Biometrics and the Belt and Road Initiative: Implications for Kyrgyzstan’s Public Health Sector

The Kyrgyz Republic’s under-digitised public healthcare system presents an emerging vector for foreign digital influence and strategic vulnerability. As China advances its global data ambitions through the Digital Silk Road and affiliated Health Silk Road, Beijing is positioning itself to dominate the digitisation of Kyrgyzstan’s public healthcare system by offering technologies often tied to opaque governance and hidden data extraction risks. 

The health sector, often overlooked in traditional security assessments, contains vast quantities of personal and biometric data. In the absence of competitive alternatives, Kyrgyzstan risks entrenching Chinese digital standards, undermining its data sovereignty —a crucial component of strategic autonomy —and becoming increasingly dependent on authoritarian-aligned technologies.

China’s Digital Expansion and Kyrgyzstan’s Authoritarian Drift

Once viewed as an island of democracy in post-Soviet Central Asia, the Kyrgyz Republic has taken an increasingly authoritarian turn under the regime of President Sadyr Japarov. While domestic drivers underpin this trajectory, China’s exportation of illiberalism has provided essential support (for further context, see: Exporting Surveillance: China’s Authoritarian Blueprint in the Kyrgyz Republic). 

Healthcare, long considered apolitical and largely removed from most conversations about security and strategic autonomy, is emerging as a new frontier. As Kyrgyzstan looks to digitise its health sector, Beijing has developed attractive biometric platforms and cloud-based data systems under the banner of the Health Silk Road. These are often deployed under non-transparent agreements that provide state-affiliated corporations access to data that can facilitate surveillance, profiling, impersonation, and behavioural predictions of populations. 

Biometric Data and Medical Records: An Overlooked Threat

Biometric data refers to unique physiological characteristics used to identify individuals. In the context of healthcare, this includes high-tech identifiers such as facial scans, fingerprints, and retinal patterns, as well as lower-tech data like height, weight, blood type, dental records, menstrual cycles, and handwritten signatures. While this may seem innocuous, when combined with the wider scope of digital authoritarianism, these figures become inadvertently sensitive. 

For example, menstrual cycle data can signal pregnancy, fertility patterns, and reproductive irregularities, making it highly valuable in contexts where states seek to control reproduction. In China, where population management has historically been enforced through the One Child Policy and, more recently, through the forced sterilisation and contraceptive use of Uyghur women in Xinjiang, the integration of biometric data into digital surveillance raises serious security and human rights concerns. 

As Chinese–Kyrgyz relations deepen, particularly through security and technological cooperation involving the increased monitoring and surveillance of Kyrgyzstan’s Uyghur population. This extension of surveillance infrastructure, combined with the digitisation of health data, risks replicating the same reproductive control measures seen in Xinjiang.

Access to a nation’s health records and biometric data also provides information about the population’s demographics, such as death rates, birth rates, and infant mortality. In addition to these historical security concerns about population demographics, this data can also identify current health risks and disparities, and forecast future health outcomes like disease outbreaks. The potential for misuse makes this information particularly vulnerable in insecure or foreign-controlled digital systems.

Unauthorised access to biometric and health data is a national security threat. It can enable foreign actors to monitor populations, coerce political figures, or target dissent. In authoritarian contexts, such data can be weaponised to suppress opposition and influence the behaviour of populations. China’s digital health exports, while framed as developmental aid, threaten to introduce asymmetric dependencies, data extraction risks, and strategic leverage over host governments.

Without robust safeguards or competitive alternatives, Kyrgyzstan’s adoption of foreign digital infrastructure risks eroding data sovereignty, weakening institutional independence, and embedding long-term vulnerabilities that can be exploited for geopolitical influence.

Healthcare Vulnerabilities 

Kyrgyzstan’s healthcare system, shaped by Soviet-era centralisation, has improved since independence through reforms and international partnerships. It now delivers both private care through clinics as well as publicly funded universal care. The public sector of healthcare remains underdeveloped and largely paper-based. Digital systems, where they exist, are fragmented, lacking both interoperability and cybersecurity protections.

This systemic weakness has real-world consequences. During a research visit to Kyrgyzstan in the summer of 2025, I sustained multiple injuries in a mountain biking accident and was treated at Bishkek’s National Hospital. While clinical care was excellent, the lack of digital infrastructure was stark: I had to photograph CT scans and X-rays with my personal smartphone and carry handwritten medical records between appointments. This informal data handling not only complicates care but also demonstrates the demand for the digitisation of Kyrgyz healthcare.

My experience is not unique. From conversations with medical professionals across Kyrgyzstan, diagnostic imaging, lab results, and patient histories are stored in siloed or offline systems with minimal security protocols. These conditions create strategic vulnerabilities, particularly as China offers digital solutions through the Health Silk Road, accompanied by opaque contracts and back-end access provisions.

Policy Recommendation

To mitigate the growing influence of Chinese digital infrastructure and strengthen Kyrgyzstan’s strategic autonomy, Canada should take a proactive role in supporting the digitisation of Kyrgyzstan’s public healthcare system. This sector, which is rich in sensitive personal and biometric data, is increasingly targeted by China through its Digital and Health Silk Road initiatives. By supporting secure, interoperable, and rights-respecting alternatives, Canada can help prevent the entrenchment of authoritarian digital norms and reduce Kyrgyzstan’s dependency on foreign-controlled platforms.

Canada is well-positioned to contribute meaningfully. With globally recognised expertise in public health, digital governance, and privacy law, Canada can offer technical support, capacity-building, and policy guidance grounded in transparency and accountability. This effort should align with ongoing multilateral initiatives, such as the UN Joint Sustainable Development Goals Fund, and be framed as part of a broader push to reinforce democratic digital governance in a strategically contested region.

Beyond technical assistance, this is also an opportunity for Canada to repair and reframe its relationship with Kyrgyzstan, particularly in light of the reputational damage caused by the Kumtor gold mine dispute. Supporting the digitisation of Kyrgyzstan’s healthcare system, which is a vital public service that directly affects citizens’ daily lives, would demonstrate Canada’s commitment to inclusive, rights-based development and offer a constructive step forward in strengthening bilateral cooperation. It would also allow Canada to project soft power, build goodwill, and lead by example in a region where democratic engagement is urgently needed to counterbalance rising authoritarian influence.

Conclusion

Kyrgyzstan’s underdeveloped and fragmented digital health infrastructure has created a strategic vacuum which has increasingly been filled by Chinese technologies deployed through the Health Silk Road. While these systems are marketed as development tools, they often come bundled with embedded dependencies that undermine data sovereignty and weaken institutional resilience. In an era where biometric and health data have become strategic assets, the digitisation of public services like healthcare is no longer a purely technical matter. It is now a question of national security and democratic integrity.

Amid China’s expanding digital influence and Russia’s declining regional engagement post-2022, Kyrgyzstan faces a narrowing set of choices. Without meaningful alternatives, it risks entrenching authoritarian-aligned technologies that could shape not only its healthcare system but also its political and civic landscape.

Canada has both the normative interest and the technical capacity to offer an alternative. By supporting the secure, rights-based digitisation of Kyrgyzstan’s healthcare sector, Canada can reinforce democratic digital norms, help safeguard strategic autonomy, and re-engage with a region that has seen limited Canadian involvement since 2021. Such a contribution would signal a shift toward inclusive, citizen-focused development, moving beyond a low-intensity economic relationship, towards a constructive, long-term partnership.