Caribbean & Central America - May 2026

On 14 April, President Nayib Bukele announced the expansion of the DoctorSV AI-assisted telemedicine service, with the second phase focusing on diagnosing and treating chronic illnesses.

DoctorSV provides free, 24-hour care as part of the Salvadorean public health system, with patients using an app to describe their symptoms before US tech giant Google’s Gemini AI helps a doctor provide a diagnosis and next steps, such as a prescription or a referral for tests.

The service was initially launched in November 2025 in conjunction with Google and the Latin American development bank (CAF), which has reportedly provided a US$75m loan to fund this second phase, and is also backed by the Pan-American Health Organisation (Paho). According to a report by prestigious medical journal The Lancet, the expanded programme has capacity to cover the whole country and can handle up to 30,000 calls per day. 

It aims to aid in the diagnosis and treatment of chronic diseases such as diabetes, hypertension and kidney disease, which currently affect around three million of El Salvador’s 6.4m people, according to the government. Better diagnosis and treatment would help to reduce the burden of these diseases by getting patients the care they need before their condition deteriorates, and the AI system aims to do so while freeing up health system capacity for more clinically complex cases.

DoctorSV is part of Bukele’s wider efforts to advance digitalisation and technological adoption in a bid to close development gaps. For example, he announced a partnership with AI firm xAI to use its chatbot Grok in the public education system in December [EB-26-01], and he has proposed using AI to improve access to the judicial system.

However DoctorSV stands out due to the fact that it has significant backing from international organisations, which plan to carry out a scientific trial to assess system performance this year. If the programme is implemented according to the design laid out in The Lancet, with continuous training for clinicians and sufficient data protection measures, it could have a positive impact for patients seeking diagnosis and treatment for minor ailments and chronic conditions by speeding up the process.

It could also benefit the economy by reducing the number of working hours lost traveling to health centres and waiting in line, and more effective triaging should free up capacity in the health system.

The rollout of the initiative has, however, been criticised by Coordinadora Nacional para la Defensa de la Salud del Pueblo Salvadoreño (Conades), a coalition of some 50 organisations representing unions, health care professionals, and academics, which launched in October 2025 in defence of the public health care system. Conades warns that it takes place amid a major reduction of health personnel and in-person services. A report by Salvadorean newspaper Diario Colatino, published in January 2026, cites Conades as saying that 7,700 health workers were laid off last year, and questioning DoctorSV’s capacity to guarantee comprehensive medical attention.

If DoctorSV is used to replace existing capacity rather than augment it, the impact of the programme will be vastly reduced. In a piece published on 30 April, investigative Salvadorean media outlet El Faro cites 2024 data as showing that El Salvador has the second-highest mortality rate from chronic kidney disease in Latin America. While the disease is the leading cause of death for people aged 40-59, the country only has one nephrologist per 853 people, according to data from the health ministry and Salvadorean Association of Nephrology and Hypertension cited by El Faro. The health system already cannot keep up with demand for treatment for kidney disease, so newly diagnosed patients are also likely to struggle to access adequate care.

There are also significant concerns around the long-term sustainability of the programme. First, the second phase is being financed by a CAF loan rather than the national budget, and the government is under pressure to cut public spending as part of a financing agreement with the International Monetary Fund (IMF). Second, DoctorSV is part of a seven-year agreement that the Bukele government signed with Google in 2023 in the areas of digital government, healthcare, and education, raising doubts as to what will happen once the contract ends. As a result, DoctorSV appears to be vulnerable to both fiscal pressures and political risks, with Google potentially able to withdraw from El Salvador and take all of the accumulated system data with it at the end of the contract term.

Take-up

A social media post by El Salvador’s presidency outlining the launch of the second phase of the rollout of DoctorSV cites Guy Nae, the director of Google Cloud for the public sector in Latin America, as saying 1.1m Salvadoreans enrolled in stage one, while 1.5m consultations were conducted. It adds that 400 establishments, such as pharmacies, are affiliated with the scheme and responding to demand, while the effectiveness (accuracy in diagnosis and treatment) stands at 93%.