The Dual-Edged Sword: Generative AI Health Assistants and the Proliferation of Cyber-Biological Threats

Abstract

Background: The integration of generative artificial intelligence (AI) into healthcare, particularly through AI health assistants for diagnostic support, clinical decision-making, and drug discovery, represents a paradigm shift in medicine. However, these powerful tools, trained on vast biomedical datasets, possess inherent dual-use potential. Their very capabilities—to understand, generate, and optimize complex biological information—could be maliciously repurposed to lower barriers to the creation of biological threats, disseminate dangerous misinformation, or circumvent established biosecurity protocols. Aim: This narrative review aims to analyze the emerging risk landscape where generative AI health assistants intersect with biosecurity. Methods: A comprehensive literature search was conducted across PubMed, IEEE Xplore, ACM Digital Library, and preprint servers (arXiv, bioRxiv) for English-language publications from 2010 to 2024. Results: The review identifies three primary threat vectors: The AI-accelerated design of biological pathogens or toxins, the generation of hyper-realistic biomedical misinformation to undermine public health, and the AI-facilitated circumvention of physical and digital biosecurity controls. The analysis highlights a critical gap in governance, technical mitigation, and practitioner awareness. Conclusion: Generative AI health assistants necessitate a fundamental rethinking of biosecurity in the digital age. Proactive, multidisciplinary collaboration among AI developers, biomedical researchers, security experts, ethicists, and policymakers is essential to develop and implement robust technical, ethical, and regulatory guardrails. Failing to preemptively address this dual-use dilemma risks eroding the immense benefits of medical AI and introducing unprecedented global catastrophic biological risks.

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