Fog of Cyberwar. From Mafia to Cyber, Historical Parallels in Combating Modern Threats

U.K. NHS Cyber Attack Overview

The recent ransomware attack on the NHS, particularly targeting Synnovis, a provider of pathology services in London, underscores the escalating threat landscape. This ransomware attack, occurring on June 3, 2024, disrupted services at major hospitals including Guy’s and St Thomas’, King’s College Hospital NHS Foundation Trusts, and several primary care services across South East London.

Attribution and Modus Operandi

The attack has been attributed to Qilin, a Russian cybercriminal group known for its financial motivations and advanced ransomware techniques. These tactics include not only encrypting data but also threatening to publish sensitive information, aiming to create maximum disruption and leverage for ransom demands.

MITRE ATT&CK framework, their operations involve:
Initial Access
Likely through phishing or exploiting public-facing applications.
• Execution
Deployment of ransomware to encrypt critical systems.
• Persistence
Maintaining access with backdoors and remote access tools.
• Privilege Escalation
Using tools to gain higher-level permissions.
• Defense Evasion
Disabling security software and logs to avoid detection.
• Credential Access
Harvesting credentials to move laterally.
• Discovery
Gathering information about the network environment.
• Lateral Movement
Locating high-value targets within the network.
• Collection and Exfiltration
Exfiltrating sensitive data to external servers.
• Impact
Encrypting data to disrupt operations and demanding ransom for decryption keys.

Psychological and Motivational Analysis

The primary motivation behind Qilin’s attack is financial gain. However, the timing and nature of the attack suggest a strategic effort to exploit vulnerabilities in critical healthcare infrastructure during a sensitive period. This tactic aligns with hybrid and asymmetric warfare strategies, aimed at destabilizing public trust and causing maximum disruption.

Broader Operational Context

The attack on the NHS could be part of a larger, coordinated campaign. The strategic targeting of healthcare services points to a deliberate effort to cause widespread disruption, potentially as part of broader geopolitical manoeuvrers.
Recent activities suggest an uptick in such operations:
• Large DDoS Attacks
Notable attacks against EU political parties around the June 8 elections,(Check Point Research) (AAG IT Services)
• Ransomware Campaigns
Increased targeting of UK, EU, and US MSPs, defense contractors, and healthcare providers since June 13 (The Record from Recorded Future)(ReliaQuest)
• Social Engineering and Financial Crimes
Complex campaigns leveraging AI models like WormGPT and deepfake technology for large-scale financial frauds (Check Point Research)

The Return of APT29 and the Diplomatic Orbiter Operation

In the shadowy world of cyber espionage, APT29, known as The Dukes, has re-emerged like a spectre from the past. Their latest operation, Diplomatic Orbiter, targets French diplomats in a manner reminiscent of their notorious SolarWinds attack in 2020/2021.

This operation, which compromised numerous international agencies, relied on exploiting simple misconfigurations like SPF or DMARC vulnerabilities to launch sophisticated phishing campaigns. Once inside, they deploy advanced tools like Cobalt Strike or Brute Ratel C4, maintaining a ghostly presence within networks for months or even years to exfiltrate strategic intelligence.

The psychology and motivation driving APT29 are deeply rooted in geopolitical strategies. By gathering vital intelligence, they aim to support significant events like the Paris Olympic Games, the Euro Cup in Germany, and upcoming elections in the UK, France, and the USA.

The eerie similarity between SolarWinds and Diplomatic Orbiter suggests that we might be on the cusp of a larger, more sinister operation. Recognizing these signs is crucial, for it allows us to prepare and fortify our defenses, transforming knowledge into power.

Geopolitical Tensions and Emerging Threats

As the fog of cyber war thickens, it becomes increasingly clear that these attacks are not isolated incidents but part of a broader geopolitical strategy. The cyber manoeuvrers by Iran-backed Houthis in the Red Sea, disrupting vital supply chains, are emblematic of this strategy.

Amplified conflicts in Ukraine and Gaza, with support from Iran and Russia, stretch global defenses thin. North Korea, allied with these states, wages an underground cyber war through the Lazarus Group, amassing funds to fuel further operations.

In this complex dance of deception and strategy, large-scale DDoS attacks by groups like Noname and Killnet often serve as preludes to ransomware campaigns.

These financially motivated operations target critical infrastructure sectors such as healthcare, water services, power grids, and supply chains, financing even larger campaigns.

The use of wipers to cause maximum disruption, as seen in the attacks on Viasat and the 5000 wind turbines in Germany, underscores the ruthlessness of these actors.

Historical and Geopolitical Parallels

The operational strategies of cybercriminal groups like Qilin mirror the tactics used by historical organized crime groups. Learning from figures like Generale Carlo Alberto dalla Chiesa, Giovanni Falcone, and Paolo Borsellino, who combated the Mafia’s ransom and terror tactics, we see parallels in how these modern threats are orchestrated.

Russia’s use of Maskirovka, or masquerade, in its digital deception campaigns, aligns closely with the Mafia’s methods of maintaining control through misinformation and fear.

Recent Geopolitical Developments

The October 7th Attack and Geopolitical Tensions

The attack on Israel by Hamas on October 7th, 2023, backed by Iran, illustrates the geopolitical manoeuvring in the region. Iran’s support for Hamas is part of a broader strategy to disrupt the normalization of relations between Israel and Arab states, and to destabilize the region. This is consistent with Iran’s strategic objectives to counterbalance US and Israeli influence. Ref. Network for Strategic Analysis (NSA)

North Korea’s Alliance and Threats

North Korea’s growing alliance with Russia and Iran, coupled with its underground cyber operations through groups like Lazarus, poses significant threats. Lazarus Group is known for its high-profile cyber attacks, generating billions to finance further operations. These alliances indicate a coordinated effort to stretch global defences and amplify conflicts, with North Korea actively participating in cyber warfare against Western targets.Ref. Network for Strategic Analysis (NSA)

Iranian APT Threats to SCADA Systems

Iranian APT groups like APT34 (OilRig) and APT39 have been targeting SCADA systems in critical infrastructure sectors, including water services and power grids. Their campaigns involve advanced tools and techniques, including social engineering and exploiting known vulnerabilities in SCADA devices.

The potential impact of these operations is significant, as demonstrated by wiper attacks in Ukraine, which have targeted power grids and other critical infrastructure. (SentinelOne) (Middle East Institute) (CISA)

Upcoming Challenges

In addition to the current threats, we must prepare for upcoming events that could be targeted by cyber threats:
• Paris Olympic Games 2024
High-profile events are prime targets for cyber attacks aimed at causing widespread disruption and garnering international attention.
• Euro Cup in Germany 2024
Similar to the Olympics, the Euro Cup presents opportunities for cyber adversaries to execute large-scale attacks.
• Elections in France, UK, and US
Elections are critical periods where information operations, misinformation, and cyber attacks can significantly impact democratic processes.

As Sun Tzu famously said, “In the midst of chaos, there is also opportunity.”
Cyber adversaries see these events as opportunities to create chaos and advance their objectives.

Proactive Measures

  1. Know Your Adversary
    Deep intelligence gathering and understanding the tactics of threat actors.
  2. Persistence and Creativity
    Constantly adapting defences to stay ahead of adversaries.
  3. Defense-in-Depth
    Implementing layered security measures.
  4. Critical Thinking and Rest
    Ensuring cybersecurity teams are well-rested to avoid burnout, which can compromise defences.
  5. Historical Lessons
    Learning from figures like Generale Carlo Alberto dalla Chiesa, Giovanni Falcone, and Paolo Borsellino to apply their strategies against modern cyber threats.
  6. Geopolitical Awareness
    Understanding the broader geopolitical landscape to anticipate and mitigate threats.


The NHS attack highlights the critical need for robust cybersecurity measures and proactive threat mitigation strategies. It emphasizes the importance of continuous vigilance, strategic foresight, and comprehensive defenses to protect against the evolving threat landscape. By understanding and anticipating the moves of threat actors, and learning from historical figures who combated organized crime, we can better prepare and defend against these modern cyber threats.

As Sun Tzu advised,
“If you know the enemy and know yourself, you need not fear the result of a hundred battles”

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