Billions of dollars in Artificial Intelligence (AI) wealth seem likely to create a new generation of philanthropists who are brimming with urgency to make a difference. What might this mean for the role of philanthropy in global health?
Two leading AI companies, Anthropic and OpenAI, plan to list their shares on the stock market in the near future. These Initial Public Offerings (IPOs) are expected to turn a significant number of founders, employees and early investors into millionaires, and some into billionaires. Many of these people have already said they intend to give a large share of their fortunes away. All seven of Anthropic’s co-founders, including its chief executive Dario Amodei, have pledged to donate 80% of their wealth.
Observers therefore expect tens of billions – that is, tens of thousands of millions of dollars – to go to charitable causes. AI wealth could soon make up a large share of all philanthropy, and some refer to it as an incoming tidal wave.
Global health will feel the impact of this wave. Anthropic’s president, Daniela Amodei, told The Economist that global health is becoming a focus for the company, which is already working with organisations across Africa to use its AI model, Claude, in health care and to forecast food insecurity. The Anthropic founders’ personal giving after their IPO windfalls is likely to follow a similar direction.
Effective altruism
Many of the soon-to-be AI millionaires and billionaires are drawn to effective altruism (EA), a movement that aims to do the most good possible by directing donations to the uses with the strongest evidence and the highest return. Key figures at OpenAI, and especially at Anthropic, are part of EA circles, and some of EA’s founding figures work at Anthropic. Much EA giving is channelled through intermediaries such as GiveWell and Coefficient Giving, which evaluate which interventions offer the best value for money and advise wealthy donors on where to give. Interventions are ranked by measures such as the net benefit generated by each additional dollar spent, a calculation that favours programmes whose effects can be counted quickly and precisely.
This approach to philanthropic giving is hardly new. It shares key characteristics with the brand of philanthropy promoted by Bill Gates, the world’s first centibillionaire, whose fortune has become a major force in global health over the past quarter century. Bringing business logics into charitable giving and treating donations as investments expected to deliver measurable returns, the Gates Foundation’s approach has been characterised as “philanthrocapitalism”.
Preference for techno-fixes
Even though some of the new AI millionaires and billionaires somewhat disparagingly refer to the Gates Foundation and its peers as ‘TradPhil’, short for traditional philanthropy, many are likely to follow a similarly philanthrocapitalist path in their global health grant making. We can expect a preference for technical interventions: for single products or tools addressing a clearly defined health problem, preferably scalable across many settings and contexts. Support for vaccine development will be popular, along with funding for potentially ‘groundbreaking innovations’ like new treatments for neglected tropical diseases (NTDs), AI-powered ultrasound devices, or chatbots offering health advice.
A commonly heard critique of this techno-focus is that it sidelines efforts to address structural determinants of health and to strengthen health systems. Donors tend to approach problems through the lens of their own expertise. For AI philanthropists, technology presents an obvious answer, even to problems whose root causes lie elsewhere.
Many interventions that rank high in terms of cost-effectiveness metrics can only be sustained within a functioning health system. Building such systems is slow, cumulative and context-specific work, the value of which is difficult to capture in a return per dollar measure. Some fear that this makes health system strengthening a poor fit for the impact assessments that effective altruism demands.
In a hurry
Patience seems to be in short supply among the new AI philanthropists. Some in the AI industry believe that Artificial General Intelligence (AGI) is only a few years away, and that their money may matter less once it arrives. Against such timelines, investments that take considerable time to bear fruit are a hard sell. After a decade in which critiques of single-disease programmes have moved into the mainstream of global health, and major funders are slowly moving away from such approaches, the new philanthropists seem likely to pull the field back towards them.
The new philanthropists may also disrupt a second fragile, recent trend. Despite the devastating impact of the 2025 aid cuts, some LMICs saw a silver lining in having a greater say over their own health priorities. Large philanthropic donations with strings attached could quickly erode that. GiveWell recently relayed an anonymous offer of $2 to $3 billion to the Global Fund to Fight AIDS, Tuberculosis and Malaria, more than the United States, its largest donor, gave last year. According to the Fund’s executives, the terms of the new “Malaria Impact Accelerator” would hand a single donor unprecedented control over which interventions countries should adopt.
Room for negotiation?
Although the first mind-bogglingly large gifts from new AI philanthropists have been announced, it remains to be seen how quickly the bulk of the new philanthropic funds will actually move. AI leaders benefiting from the upcoming IPOs have a clear financial incentive to give away money, because it spares them a large tax bill. For instance, selling $10 million worth of stock could cost them more than $3.5 million in tax. Yet claiming the tax benefit does not require charitable dollars to be spent straight away. Much of the new philanthropy is expected to pass through donor-advised funds (DAFs), which are accounts that grant the donor a tax deduction as soon as the money is deposited but leave them free to decide only later which causes they will support. Some $326 billion already sits untouched in US DAFs.
Despite the proclaimed hurry to do good, a lot of the money may therefore spend a considerable time standing still. Perhaps that offers an opening? Time for the global health community to make the case for less glamorous investments, and to persuade the new philanthropists that bottom-up approaches to strengthening health systems deserve their support.
Image by Oleksandr Latkun from Noun Project (CC BY-NC-ND 2.0)