CVE-2024-46532 is a critical SQL Injection vulnerability identified in OpenHIS version 1.0, a healthcare information system. The vulnerability exists in the refund function of the PayController.class.php component, where user input is improperly sanitized before being incorporated into SQL queries. This flaw allows an unauthenticated attacker to inject malicious SQL commands, potentially leading to arbitrary code execution on the backend database server. The vulnerability is classified under CWE-89, indicating classic SQL Injection issues. The CVSS v3.1 base score is 9.8, reflecting its critical nature with attack vector being network-based (AV:N), no privileges required (PR:N), no user interaction needed (UI:N), and full impact on confidentiality, integrity, and availability (C:H/I:H/A:H). Exploitation could allow attackers to extract sensitive patient data, modify or delete records, or execute commands on the host system, severely compromising the healthcare environment. No patches or exploit code are currently publicly available, but the vulnerability is publicly disclosed and should be treated as urgent. The lack of authentication requirements and the direct impact on critical healthcare data systems make this a high-risk vulnerability.

The impact of CVE-2024-46532 is severe for organizations using OpenHIS 1.0, particularly healthcare providers managing sensitive patient information. Successful exploitation can lead to full compromise of the database, exposing confidential health records, financial data, and personally identifiable information (PII). Attackers could alter or delete critical data, disrupt healthcare operations, and potentially execute arbitrary code on the server, leading to system downtime or ransomware deployment. The breach of confidentiality can result in regulatory penalties under laws such as HIPAA or GDPR. The integrity loss undermines trust in healthcare data accuracy, potentially affecting patient care decisions. Availability impact can disrupt healthcare services, causing delays or denial of care. Globally, healthcare institutions relying on OpenHIS or similar open-source healthcare management platforms are at risk, with potential cascading effects on public health infrastructure and patient safety.

To mitigate CVE-2024-46532, organizations should immediately review and update the refund function in PayController.class.php to implement parameterized queries or prepared statements, eliminating direct concatenation of user inputs into SQL commands. Input validation and sanitization should be enforced rigorously, ensuring only expected data types and formats are accepted. Database user permissions should be minimized to restrict the ability to execute arbitrary commands or access unrelated data. Network-level protections such as web application firewalls (WAFs) can provide temporary mitigation by detecting and blocking SQL injection patterns. Organizations should monitor logs for suspicious database queries or anomalies in refund processing. If patches become available from OpenHIS maintainers, they should be applied promptly. Additionally, conducting security code reviews and penetration testing on the application can help identify and remediate similar vulnerabilities. Finally, maintaining regular backups and an incident response plan will help mitigate damage in case of exploitation.