Bukele bets on Google to build world’s best health system as medical sector decries layoffs
The 30,000 daily appointments are human doctors treating patients with AI support. But AI agents will be doing this separately and in parallel, he specified.
El Salvador’s President Nayib Bukele announced on Tuesday in a national broadcast the launch of the second phase of Dr. SV, a public health application developed with Google Cloud that incorporates artificial intelligence based on the Gemini model to detect, diagnose and monitor patients with chronic diseases such as diabetes, hypertension and kidney conditions.
I’m very excited, because we are creating the best health system in the world, Bukele said during a meeting at the presidential palace with Guy Nae, Google Cloud’s Director for the Public Sector in Latin America, and specialists in medicine and artificial intelligence. At some point we will be treating cancer, performing surgeries, he added.
The platform, launched in November 2025, allows Salvadorans to access free medical consultations via video call around the clock, receive electronic prescriptions through QR codes and arrange laboratory tests at no cost. Since launch it has reached 1.1 million users, managed 1.5 million appointments and includes more than 400 affiliated pharmacies and laboratories. It currently handles 18,000 daily calls, with capacity for 30,000, according to Nae.
The second phase introduces algorithms that detect risk factors through digital questionnaires, automatically generate lab orders and provide personalized follow-up for chronic patients, including alerts for treatment abandonment. Specialist Edgardo Von Euw explained that the program addresses a serious reality: roughly three million Salvadorans live with at least one chronic disease, but only six in ten hypertension patients are aware of their diagnosis. For kidney disease, the figure drops to one in ten.
Bukele clarified that human doctors remain in charge of consultations. The 30,000 daily appointments are human doctors treating patients with AI support. But AI agents will be doing this separately and in parallel, he specified.
Stella Aslibekyan, a PhD in epidemiology from the University of Alabama at Birmingham, said during the presentation that a clinical trial is underway to evaluate the AI’s impact on diagnostic accuracy, supervised by El Salvador’s Ethics Committee — though the body has no known public profile.
The announcement comes amid strong criticism from the medical sector. The government dismissed 7,700 health system employees last year, including general practitioners, specialists, nurses and primary care staff. The National Coordinator for the Defense of Health of the Salvadoran People (Conadesa) has accused the program of being a disguised privatization of healthcare.
Data protection experts have warned about the risks of handing population health data to systems controlled by a foreign private company. The agreement between El Salvador and Google spans seven years and allocates at least $500 million for implementation, though contract details remain classified.
The experiment follows Bukele’s adoption of Bitcoin as legal tender, which he withdrew last year after investing $329 million in its implementation without achieving significant adoption, according to the organization Cristosal.
