Ahead of this week’s Society of Nuclear Medicine meeting and the July gathering of the Organization for Economic Cooperation and Development, the United States is announcing steps to ensure the reliable supply of medical isotopes while minimizing the use of highly enriched uranium (HEU) for civilian purposes. In order to maintain access globally to reliable supplies of the isotope molybdenum-99 (Mo-99) for legitimate medical purposes, the United States is accelerating commercial projects that produce Mo-99 domestically without the use of HEU. The United States is committed to eliminating the use of HEU in all civilian applications, including in the production of medical radioisotopes, because of its direct significance for potential use in nuclear weapons, acts of nuclear terrorism, or other malevolent purposes. Today there is wide agreement that civilian use of HEU should be minimized, and the U.S. is working with international partners to eliminate its use in radioisotope production worldwide, consistent with this commitment.
Medical patients in both the United States and around the world require access to reliable supplies of radioisotopes for use in medical procedures. Over the past few years, the supply of the short-lived medical isotope Mo-99 and its daughter product technetium-99m have encountered periods of shortage and unreliability, as Mo-99 is produced in only a few facilities around the world, most of which are reaching the end of their projected life, and none of which are located domestically. Moreover, most of the facilities that currently produce large-scale quantities of Mo-99 use HEU targets in the production process.
The ongoing success of worldwide efforts to assure the supply of medical isotopes will depend upon the transition of the industry to a full cost-recovery, market-driven model, along with the conversion of the current global medical isotope production from HEU to low enriched uranium (LEU) targets. The United States will support these efforts by taking the following actions, consistent with policy principles developed and adopted by the international community, including those outlined in the Communiqué of the Seoul Nuclear Security Summit in 2012 and by the Organization for Economic Cooperation and Development’s Nuclear Energy Agency:
•Calling upon the Mo-99 industry to voluntarily establish a unique product code or similar identifying markers for Mo-99-based radiopharmaceutical products that are produced without the use of HEU;
•Preferentially procuring, through certain U.S. government entities, Mo-99-based products produced without the use of HEU, whenever they are available, and in a manner consistent with U.S. obligations under international trade agreements;
•Examining potential health-insurance payment options that might promote a sustainable non-HEU supply of Mo-99;
•Taking steps to further reduce exports of HEU that will be used for medical isotope production when sufficient supplies of non-HEU-produced Mo-99 are available to the global marketplace;
•Continuing to encourage domestic commercial entities in their efforts to produce Mo-99 without HEU during the transition of the Mo-99 industry to full-cost-recovery, and directing those resources to the projects with the greatest demonstrated progress; and
•Continuing to provide support to international producers to assist in the conversion of Mo-99 production facilities from HEU to LEU.
The reliability of supply of medical isotopes is a priority for the United States. The actions and approach outlined above will directly support the long-term reliability of supply of this vital commodity for the medical community and ensure that patient needs are met both in the United States and around the world, all the while continuing to minimize the use of HEU in the civilian sector.