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Global Medical Isotope Shortage Follows S. Africa Plant Leak

A leak at a South African Nuclear Energy Corp. plant this month has caused a global shortfall in the supply of isotopes used in millions of medical procedures every year, including treatment and diagnosis of cancer.

“No production is currently taking place, leaving a big shortage in the international market,” Don Robertson, managing director of NTP Radioisotopes SOC Ltd, said in an e-mailed response to questions. NTP produces a quarter of the world’s medical radioisotopes, making it the second-largest manufacturer, he said.

The isotopes are used to provide diagnostic information about the organs or to treat conditions such as non-Hodgkin’s lymphoma, thyroid and liver cancer, according to the World Nuclear Association. Tens of millions of nuclear medicine procedures are performed each year, and demand for radioisotopes is increasing rapidly, the association said on its website.

A release of noble gas and iodine occurred on Nov. 2 at the NTP plant in Pelindaba, about 30 kilometers (19 miles) from the capital Pretoria. An investigation was concluded on Nov. 12 and the company expects measures to be implemented by early next week, Robertson said. A start is dependent on the National Nuclear Regulator’s authorization to reopen the facility. The regulator is conducting an independent review.

Drill Down

“Our investigation is ongoing,” Gino Moonsamy, a spokesman for the National Nuclear Regulator, said in a phone interview. “We need to drill down to find out what the root cause was. It could take a while.”

The outage is causing a shortage of molybdenum-99, used in medical procedures and nuclear scans and exported by NTP to 60 countries, as well as technetium-99m, used in disease diagnosis, according to Robertson. The company also exports iodine-131, used for thyroid gland diseases including hyperthyroidism and to treat tumors of the thyroid gland.

“Patients are affected as early detection of most diseases assisted by using nuclear medicine greatly enhances the possibility of early and accurate diagnosis,” Robertson said. “Therefore, many patients would not be able to undergo these scans due to the shortage.” Robertson said.

Backup Partners

While NTP’s local market will only experience a limited shortage, the international market has suffered because of the lead times involved for backup partners to scale up manufacturing capacity for such large quantities of isotopes, he said. While the deficit won’t be fully addressed for the duration of the NTP outage -- because the company’s market share is too big -- it will be limited starting next week when other suppliers’ capacity has increased, according to Robertson.

“Many international professional bodies are meeting daily to consider options to mitigate against this shortage,” Robertson said.

The National Research Universal reactor at Chalk River Laboratories, Ontario, is the world’s largest producer of medical isotopes, according to Atomic Energy of Canada Ltd.

The shortage from South Africa “is only one part of a larger problem of sustaining production and supply of radioisotopes” as older reactors shut down, Brian Neilly, president of the British Nuclear Medicine Society , said in a phone interview.

The society and the Organisation for Economic Cooperation and Development’s Nuclear Energy Agency are working on solutions as demand for radioisotopes is expected to rise about 2 percent each year until at least 2030, he said.

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