Medical Isotopes: Balancing Supply and Security

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Anya Loukianova

Research Associate, The James Martin Center for Nonproliferation Studies

Every year, medical professionals worldwide carry out more than 30 million procedures using the medical isotope technetium-99m (Tc-99m), which is derived from its parent, molybdenum-99 (Mo-99). 

Mo-99 is often produced using weapons-useable highly enriched uranium (HEU), a major target for terrorist groups seeking to build a nuclear device. To address this risk, the U.S. government has been working with international partners to minimize the use of HEU in civilian applications, with a recent push to convert aging reactors that use HEU for Mo-99 production to processes using LEU or alternative methods. 

The challenge?  Countries must accomplish such conversion without interrupting the supply of medical isotopes vital to medical procedures. Growing demand for Mo-99 in the medical field, a history of shortages and a planned shut-down of one of the radioisotopes' major producers raises uncertainties, which Anya Loukianova explores in a new Center for Nonproliferation Studies issue brief.

"The leadership of key countries, and especially those involved in conversion or new HEU-free production, has been essential in building the emerging HEU-free Mo-99 production consensus," writes Loukianova. "This international commitment could be further strengthened through continued rigorous technical cooperation and high-level dialogues in fora such as the Nuclear Security Summit."

The onus for change must be on consumer countries of Mo-99 and health regulators to help shape demand for Mo-99 produced without weaponse-useable HEU. "Finding a timely solution to the dual challenge of making the Mo-99 supply chain reliable and HEU-free is critical," writes Loukianova.

Read the issue brief.

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