Partners in Prevention Industry Backgrounders
Over 10,000 hospitals worldwide actively use radioisotopes to provide information about the functioning of patients’ organs or to treat disease. In fact, radiopharmaceutical research involves radioisotopes attached to drugs administered to patients for more than 50 different types of diagnostic tests. The most common radioisotope used in diagnosis is technetium-99, which is used in approximately 80 percent of all nuclear medicine procedures worldwide. In the US alone, there are some 18 million nuclear medicine procedures per year.
The bulk of radioisotopes used are derived from highly enriched uranium (HEU), and the nonproliferation community rightly has raised concerns about the lack of regulation at both ends of the radiopharmaceutical industry spectrum – from the major producers of medical isotopes to the sites that utilize the material. For instance, the process to produce molybdenum-99 (the parent radionuclide of technetium-99) only consumes up to three percent of the available HEU. The leftover HEU is not recycled and, consequently, significant amounts of weapons-grade material are stockpiled in relatively poorly secured commercial locations.
Today, there are only four major producers of medical isotopes: MDS Nordion (Canada), TycoHealthcare/Mallinckrodt (The Netherlands), Institut National des Radioéléments (Belgium), and NECSA/NTP (South Africa). Collectively, they provide more than 95 percent of the global supply of medical isotopes. The nonproliferation community has advocated for the conversion of these facilities from HEU to low-enriched uranium (LEU) production. While many assert this would have little impact upon cost and pricing, the industry has proven resilient to firm commitments to conversion, largely because they are unwilling to bear the upfront cost of conversion.
At the other end of the supply chain are those sites where radioisotopes are utilized. Most point to hospitals and other treatment centers, but radiological sources also are used in the construction and petroleum industries, as well as in the airline industry. Proliferation concerns are raised over the possibility of non-state actors obtaining these materials from unsecured locations and using them in a radiological dispersion device. Elected officials and NGOs have pointed to the ease with which highly dispersible material, such as Cesium 137, could be removed from inadequately secured sites. In response, the Department of Energy’s Global Threat Reduction Initiative launched a voluntary program to secure this material. Elected officials and nonproliferation advocates alike closely track momentum in achieving 100 percent security over these sensitive sources.
While these efforts at opposite ends of the supply chain are positive steps, they ignore a critical component: the actors between the radioisotope production companies and the end-users. These technology innovators and diagnostic machine fabricators represent a critical hub in the research, development, and manufacturing market. Furthermore, they hold the lion’s share of leverage against producers, and fully control the products utilized by end-users. As such, they represent a critical untapped opportunity to develop market-based self-regulation.