Converting Radiopharmaceutical Production to LEU: How to Close a Vulnerable Proliferation Pathway

"How many doctors are aware that they contribute to a nuclear proliferation and terrorist risk every time they order a nuclear bone or lung scan, or other procedure utilising an isotope produced using HEU, directly usable in a nuclear weapon? Almost certainly very few. How many of the patients involved are aware of this? Probably even fewer."

Tilman Ruff, Bill Williams, IPPNW doctors writing about HEU in Medicine, Conflict and Survival in 2007

Nuclear weapons alone have the capacity to exterminate much of the human population and severely damage most ecosystems in the space of a few short hours. Creating a world without nuclear weapons is IPPNW's most important goal, and is the reason we launched the International Campaign to Abolish Nuclear Weapons - ICAN.

While it may seem like a small matter compared with the task of eliminating some 25,000 nuclear weapons from the world's arsenals, the medical profession has a proliferation problem in its own backyard.

The bulk of the radioisotopes used in diagnostic medical procedures are currently derived from highly enriched uranium (HEU), which is used to fuel plutonium and tritium production for nuclear weapons. The four major competitors in the international medical isotope marketplace provide more than 95% of the global supply, from seven different reactors: MDS Nordion (Canada), TycoHealthcare/Mallinckrodt (Netherlands), Institut National des Radioelements (Belgium), and NECSA/NTP (South Africa).

Health care professionals have an obligation to hasten the phase-out of medical commerce in HEU and so terminate one of the most vulnerable pathways to the much-feared "terrorist bomb." Fortunately, there are no technical obstacles to converting to low-enriched uranium (LEU) sources for these radiopharmaceuticals. Moreover, no new LEU needs to be produced, as existing supplies are more than sufficient.

IPPNW has launched a medical campaign, as part of ICAN, to accelerate the global conversion of these radioisotope-producing reactors to LEU. The objective of the campaign is the passage of resolutions by medical associations around the world, in order to place irresistible pressure on those few producers who continue to use HEU needlessly.

IPPNW's Draft Policy on Medical Isotope Production

Health Professionals have a strategic opportunity and obligation to advance the elimination of medically related commerce in - and use of - HEU, closing one of the most vulnerable pathways to a terrorist nuclear bomb.

We urge:

1. Radiopharmaceutical suppliers to expedite universal conversion of isotope production targets and reactor fuel from HEU to LEU as soon as possible.

2. The governments of Belgium, Canada, France, the Netherlands and South Africa, and Euratom, to require isotope production reactors within their jurisdiction, utilising HEU fuel or targets, to promptly be converted to LEU fuel and targets.

3. All governments and regional authorities to require any new isotope production facilities within their jurisdiction not to use HEU.

4. The governments that supply HEU (France, Russia, South Africa, USA and UK) to institute compelling incentives - preferably coordinated - for radiopharmaceutical producers to convert to LEU in the near future. Such measures could include a cut-off date of no more than 3 - 5 years for continued HEU supply, possibly in combination with substantial and progressive escalation in the price charged for HEU.

5. Development of a code of conduct against the civilian production, trade and use of HEU. Stockpiled and waste HEU should be converted into useable LEU.

6. Priority and funding for research and development of non-reactor generation of isotopes currently sourced from reactors, in particular molybdenum-99.

7. As an interim measure, investigation of the possibility of utilising existing nuclear power and/or research reactors to produce medical isotopes, to minimize the need for construction of new dedicated isotope production reactors.

8. Clinicians to optimize clinical application of non-ionising and non-reactor based ionising radiation imaging technologies. Clinicians should consider and use alternatives to procedures which require reactor-produced isotopes whenever the care of their patients can be served as well or better by alternatives which either avoid ionising radiation altogether (such as ultrasound and MRI), utilise non-reactor isotopes (such as PET scanning), or utilise conventional X-rays (such as modern spiral CT scanning).

9. Radiopharmaceutical distributors and nuclear medicine departments to procure isotopes produced without HEU wherever possible; and/or encourage their supplier(s) to convert to LEU.

10. Other national, regional and international medical organizations, including the World Health Organisation and World Medical Association to become apprised of this issue, adopt similar policies, and coordinate and lead international medical efforts to eliminate HEU from radiopharmaceutical production worldwide as quickly as possible.

Participate in the campaign

Use the links below to download resources that can help you learn more about the problem of HEU and medical isotope production. Then present the facts to your local and national medical associations, and ask them to pass a resolution endorsing the conversion policy recommended by IPPNW and a wide range of medical and proliferation experts.

Finally, let us know when your medical association passes a resolution. You can send news and questions about the campaign to Dr. Tilman Ruff: tar [AT] unimelb.edu.au.

Resources

Weapons-grade Uranium and Radiopharmaceutical Production: An IPPNW Fact Sheet [PDF 825KB]

Proliferation dangers associated with nuclear medicine: getting weapons-grade uranium out of radiopharmaceutical production. Medicine, Conflict and Survival article by Williams and Ruff [PDF 198KB]

Powerpoint Presentation: Doctors and the 'Terrorist Bomb: proliferation dangers associated with radio-pharmaceutical production [PPT 4.7MB]

Draft IPPNW Policy on HEU and Radiopharmaceutical Production [PDF 59KB]

Getting nuclear-bomb fuel out of radiopharmaceuticals. Lancet commentary by Bill Williams and Tilman Ruff. March 8, 2008 [PDF 115KB]

For more information about the International Campaign to Abolish Nuclear Weapons (ICAN), contact John Loretz, Program Director, IPPNW, 727 Massachusetts Ave., Cambridge, MA 02139; 617-868-5050, ext. 280.