When Bill Gates rolls out his “philanthropic” agenda in Africa, caution is warranted — especially when OpenAI is now part of the effort. The Gates Foundation’s push into African health care reflects a familiar pattern of imposing Western industrial models that have already failed farmers and communities. The same foundation that drove AGRA’s disastrous green revolution — increasing hunger by 31% while degrading soil and locking farmers into costly corporate inputs — now seeks to reshape health systems with Global North AI, sidelining local knowledge, accountability and sovereignty.