# zkFL-Health: Blockchain-Enabled Zero-Knowledge Federated Learning for Medical AI Privacy

arXiv: https://arxiv.org/abs/2512.21048 · HTML: https://mlsanity.com/paper/2512.21048/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 11 of its 28 references that are in the map.
- First posted on arXiv 24 Dec 2025.

## Builds on (most cited first, 11 of 11)

- [Communication-Efficient Learning of Deep Networks from Decentralized Data](https://mlsanity.com/paper/1602.05629/) (2016)
- [Advances and Open Problems in Federated Learning](https://mlsanity.com/paper/1912.04977/) (2019)
- [Deep Learning with Differential Privacy](https://mlsanity.com/paper/1607.00133/) (2016)
- [Membership Inference Attacks against Machine Learning Models](https://mlsanity.com/paper/1610.05820/) (2016)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [Deep Leakage from Gradients](https://mlsanity.com/paper/1906.08935/) (2019)
- [Inverting Gradients -- How easy is it to break privacy in federated learning?](https://mlsanity.com/paper/2003.14053/) (2020)
- [The Future of Digital Health with Federated Learning](https://mlsanity.com/paper/2003.08119/) (2020)
- [Blockchained On-Device Federated Learning](https://mlsanity.com/paper/1808.03949/) (2018)
- [BlockFLA: Accountable Federated Learning via Hybrid Blockchain Architecture](https://mlsanity.com/paper/2010.07427/) (2020)
- [Fantastyc: Blockchain-based Federated Learning Made Secure and Practical](https://mlsanity.com/paper/2406.03608/) (2024)

## Abstract (arXiv)

Healthcare AI needs large, diverse datasets, yet strict privacy and governance constraints prevent raw data sharing across institutions. Federated learning (FL) mitigates this by training where data reside and exchanging only model updates, but practical deployments still face two core risks: (1) privacy leakage via gradients or updates (membership inference, gradient inversion) and (2) trust in the aggregator, a single point of failure that can drop, alter, or inject contributions undetected. We present zkFL-Health, an architecture that combines FL with zero-knowledge proofs (ZKPs) and Trusted Execution Environments (TEEs) to deliver privacy-preserving, verifiably correct collaborative training for medical AI. Clients locally train and commit their updates; the aggregator operates within a TEE to compute the global update and produces a succinct ZK proof (via Halo2/Nova) that it used exactly the committed inputs and the correct aggregation rule, without revealing any client update to the host. Verifier nodes validate the proof and record cryptographic commitments on-chain, providing an immutable audit trail and removing the need to trust any single party. We outline system and threat models tailored to healthcare, the zkFL-Health protocol, security/privacy guarantees, and a performance evaluation plan spanning accuracy, privacy risk, latency, and cost. This framework enables multi-institutional medical AI with strong confidentiality, integrity, and auditability, key properties for clinical adoption and regulatory compliance.