"Why rural Americans? The same amount of cash will go a lot further and likely be more effective in rural areas of other countries."

Again, the data goes into an open global repository that DOES help the entire world. We will all learn from it. When our house is currently on fire, I think we should deal with that first.

It's also "yes, and". Gates Foundation (among others) is working on other areas of the world and has vastly more money.