A Hard Pill to Swallow

Last May, a trio of bustling nurses surrounded a Covid-19 patient in Bahrain. The nurses took the patient’s blood pressure, served food, and dispensed medication. They worked day and night, without a day off and without a complaint. They weren’t designed to complain; they were robots.

As Bahrain aims to become a regional leader in pharmaceuticals and medicine, the country is rolling out a range of innovative technologies.

Robot nurses are just one of them. Starting in 2021, Bahrain’s government will use blockchain to track every bottle of medicine moving around the kingdom. Blockchain is the same technology behind Bitcoin and other cryptocurrencies. A Bahraini company—whose chair is a member of the ruling family, and whose senior staff is largely Western—will create separate barcodes for every pharmaceutical product entering the country. The government will be able to track medicine directly from overseas manufacturers, to warehouses within Bahrain, through pharmacies, and all the way to individual patients. It will be able to monitor the age of each medication and its storage conditions; it will also be able to trace adverse health events straight back to the drug supplier.

While the system is designed to operate at low cost, a hidden cost may lie in the privacy patients are forced to give up.

Proponents of the new system—including the Bahraini government—argue that it will help block counterfeit pharmaceuticals and prevent critical drug shortages. But the system also makes the health care system more vulnerable to cyberattack. Bahrain has some experience in this regard: a cyberattack in 2019 crippled computers at the Bahrain Defense Force Hospital for four days.

Critics also argue that blockchain is incompatible with Bahrain’s data protection laws, and they worry openly that collecting additional information about patients will expose sensitive data to malign actors. They also argue that blockchain pharmaceutical systems don’t adequately ensure data privacy or allow for patient consent.

The collision of health care data and privacy is becoming a growing issue in Bahrain. Earlier this year, Bahrain rolled out a Covid-19 contact tracing app that performed live-tracking of users’ locations, raising fears that the information could be used for many purposes completely unrelated to Covid-19.

For many Bahrainis, giving up more privacy in the name of public health may be a hard pill to swallow.

This article is part of the CSIS Middle East Program series Mezze: Assorted Stories from the Middle East.