Canada and the Precarious World Medical Isotype Supply

2009-06-17 | |
Last updated: 2009-06-17

When it comes to treating many cancers, radioactive medical isotopes are a powerful tool for targeting cancer cells and destroying them. In the US alone, some 13 million medical procedures are performed annually using such isotopes that are created in small nuclear reactors around the world. Unfortunately, due to the costs of building and maintaining such reactors, many of these facilities are in an advanced state of age and often fail or cannot be repaired at all. This makes the supply of the isotopes to medical practitioners very unstable.

In particular, the recent shutdown of Atomic Energy of Canada Limited’s (AECL) medical isotope reactor, due to a water leak has created a significant shortage of isotopes and caused rationing in many parts of the US and Canada. This is because the reactor is responsible for producing a third of the isotopes used worldwide. Because of the short life span of the isotopes with a half-life of only 67 hours, they cannot be stockpiled for a long duration. Thus, the failure of the Canadian government and government corporation AECL to come up with a backup plan in advance of the highly expected failures of the reactor shows a considerable lack of leadership.

It is not that alternatives to the AECL reactor are unavailable, but rather, they were not explored in a proactive manner by the Canadian government. In particular, McMaster University in Ontario, Canada has been running its reactor 16 hours a day, 5 days a week and would only need to ramp up production to be able to be able to supply 20% of the North American market for isotopes. Unfortunately, this sort of ramp up takes many months and forethought, neither of which the Canadian government has.

Another failure from several parties in the Canadian government over the years has been the bungling of the creation of the MAPLE isotope reactor as a replacement for the current 50-plus year old reactor. With budget overruns of 600%, its creation was obviously not managed well, but the decision to cancel the program without first understanding the implications was a bad decision of only the current Conservative government. It’s usually a good idea to cut one’s losses on expensive projects that exceed their budget, but having a backup plan is rather important in such situations.

Combine these failures with the recent announcement by Canadian Prime Minister Stephen Harper that Canada will be getting out of the medical isotope business and we can see that the Canadian Government is completely dropping the ball for the international medical community. At the same time, Canada is giving up a strong source of revenue and market leadership that has come from being a major world player in the creation of medical isotopes. Canada will also likely experience higher costs for its Universal Health Care system in having to buy the isotopes abroad.

With 90% of the US isotope production coming from outside the country and a large portion coming from Canada directly, US patients will suffer from this lack of planning by a foreign government. Unfortunately, the US government has also dropped the ball in this respect by not ensuring home-grown supplies or alternate producers. Canadians will also suffer as a result, but for a shorter time since the Canadian government has scrambled to find a replacement supplier for the isotopes within Canada and has found an Australia producer capable of meeting the demand.

When we consider how much voters value health, its sad to see situations in which governments are completely clueless and unprepared to meet the health needs of their citizens. Hopefully, the Canadian government can come up with a long-term plan instead of mostly flailing helplessly. However, their last minute effort to fund some research into creating isotopes outside of reactors is not much of a plan. Hopefully, the US government will craft a plan to reduce their dependence for isotopes from other countries. However, with the handling so far, any optimism in future management of this situation is likely seriously misplaced.

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