The first principles guiding our work with AI

After years of progress toward health equity and poverty reduction, we are seeing a widening gap between countries and communities on nearly all metrics of global development. The development of new technologies and their application in resource-poor settings has been one way to address these gaps. It will take concerted action by governments, the private sector, philanthropies, and civil society to develop the solutions needed to regain footing on the Sustainable Development Goals that we use to track progress.  

Since its inception, the Bill & Melinda Gates Foundation has focused, through its partnerships and grantmaking, on applying innovation to help accelerate progress, promote human potential, and address long-standing inequities. Working with our partners we continually scan the horizon for innovations, from drought-resistant seeds to mRNA vaccines, that can make an impact toward health and development goals.  

By almost all estimations, rapid advances in artificial intelligence, or AI, will make AI technology broadly available and transformative across societies and economies, with the potential to fundamentally alter the way people communicate, work, learn, and improve their well-being. In the areas where the Gates Foundation works, it is easy to imagine powerful uses for AI in everything from speeding medical breakthroughs and addressing the impacts of climate change to boosting learning outcomes and increasing agricultural production for smallholder farmers. The foundation has invested in dozens of applications of machine learning to health and development use cases to date. More recently, the rapid development and availability of large language models, like ChatGPT, has fundamentally changed what may be possible using AI. Potential gains will only be realized if the technology is implemented with the beneficiaries participating in its development. The speed with which AI is being developed poses a moment of opportunity and risk—will their creation and application be inclusive, reflecting the needs of lower-income countries, or will they be applied inequitably and further the gaps we’ve seen?  

Earlier advances in technology have delivered uneven benefits in many parts of the world for a variety of reasons, but lack of access to innovation is the primary reason people in low-resource settings often do not see benefits in a timely, fair, and consistent fashion. Like any new set of technologies, it is vital to approach the potential uses of AI with care and caution, particularly from the perspective of populations who have historically been left behind in realizing the benefits of innovations. It is also critical to acknowledge the risks associated with the spread of misinformation and the potential misuse of information facilitated by AI. In the realm of health and development, where accurate and reliable information is essential, the consequences of misinformation can be particularly damaging. Intentional design and collaboration with those who stand to benefit are critical to innovation having the desired impact, which we measure in lives saved and opportunities provided for people to achieve their full potential.  

The use of AI for development requires specific considerations because of the nature of how and where large language models have been created, as well as the perceptions which accompany them. These models are built around the analysis of large data sets combined with algorithms and statistical models to find and utilize patterns. Marginalized communities have not had a seat at the table to inform the models, so the statistical representations in these models may be less accurate than for regions with better-represented data. This makes error rates and the risk of perpetuating pre-existing biases for AI utilizing such data significantly more likely. There is a real risk associated with AI tools if caution and oversight are not exercised. If not properly managed, these tools can inadvertently reinforce biases, perpetuate existing inequalities, and propagate misinformation. We must intentionally work to mitigate these limitations.  

Recognizing both the potential benefits and risks of AI and its rapid development, in March 2023 the foundation established an internal Global AI Task Force to help serve as a coordinating mechanism to define the role of AI as it relates to the foundation’s work, recognizing the many facets of our work and the evolving nature of this technology. The task force was created to drive a responsible and organized approach to exploring the foundation’s engagement with AI usage and help map a way forward that is safe, ethical, and equitable. Additionally, the foundation is establishing an ethics and equity advisory committee drawn from outside experts which will share insights on program design, ethical AI practice, provide accountability within the organization and our grantees, and advise how best to guard against bias and unintended consequences. 

Our focus on access and equity is fundamental to our current and future work with AI. We understand that introducing AI into resource-limited settings may present unique risks, and we are committed to mitigating these through continuous research, collaboration, and open communication with stakeholders. As the foundation engages in work that leverages the power of AI, we will be guided by a set of first principles that shape our initial approach and aligned with our core mission—to help create a world where every person has the opportunity to live a healthy, productive life. These principles will be refined and adapted as we engage with partners and other outside experts, as we learn based on experience, and as future developments in AI technology evolve. 

These are early days in the development of AI and its uses to better human health and development. We recognize the inherent risks involved with AI and the need to address them responsibly. We also look forward to exploring the opportunities to harness this revolution to overcome challenges that to date have been intractable. As we have done with emerging technologies and platforms like mRNA for vaccines and therapeutics, genetic sequencing for disease identification and tracking, and other transformational tools, we are engaged early and to bend the curve towards equity. We will have much more to say about this topic here and across foundation channels.