The High-level Group on the Security of Supply of Medical Radioisotopes
The NEA established the High-level Group on the Security of Supply of Medical Radioisotopes (HLG-MR) in 2009. The HLG-MR is comprised of 20 experts who are representatives from the governments of Australia, Belgium, Canada, France, Germany, Italy, Japan, Korea, the Netherlands, South Africa and the United States, as well as from the European Commission and the International Atomic Energy Agency (IAEA). Members of the HLG-MR are nominated by governments. They include experts from government agencies and from research and industrial organisations with interests in medical radioisotopes.
The principle objective of the HLG-MR is to oversee and assist, where necessary, efforts of the international community to address the challenges of medical isotope supply reliability.
The use of medical radioisotopes is an important part of modern medical practices. One of their principal uses is for nuclear diagnostic imaging techniques. These techniques are powerful, non-invasive tools that allow for the identification of common diseases such as heart disease and cancer at an early stage, tracking disease progression and providing predictive information about likely success of alternative therapy options. This information permits a precise and accurate management of the disease and may significantly alter medical decisions, for example reducing the need for surgical intervention. Every year, over 40 million people globally benefit from such nuclear medicine testing.
Over the last few years there have been a number of supply shortages of Molybdenum-99 (Mo-99) and its decay product, Technetium-99m (Tc‑99m), the most widely used medical radioisotope. These isotopes decay within a matter of days; therefore they must be produced continually and used efficiently in order to meet demand and make the best use of the short-lived isotopes. Most recently, the extended unexpected shutdown of Canada’s research reactor – which produces approximately 35 percent of world Mo-99 supply – has highlighted concerns around the reliability of supply. Currently, five multipurpose research reactors aged between 42 and 52 years produce over 95 percent of the world’s supply of Mo-99. These aging facilities face challenges in maintaining a consistent supply to the health community. Disruptions in this supply chain interrupt the availability of medical testing for millions of patients around world.
The HLG-MR has begun work toward increasing the reliability of supply, focussing first on ensuring that supply and demand information is available and shared amongst all stakeholders and that the available supply is utilised as efficiently as possible. The HLG-MR is also assessing options to increase short-, medium- and long-term production.
As part of the work of the HLG-MR, the NEA is undertaking an economic study of the Mo-99 and Tc-99m supply chain. The study is intended to develop a solid factual basis to determine if economic factors have played a role in the current medical isotope supply situation and if so, to provide recommendations to create an environment that encourages sufficient investment in medical radioisotope production and related infrastructure.
The NEA and the HLG-MR recognise that there are a number of other on-going forums related to the reliability of medical isotope supply and is working to ensure that efforts are not duplicated. The NEA was requested to become engaged in this issue to bring added value to the ongoing work and to support member countries. Bringing the international community together to discuss, share and learn, and applying NEA expertise on nuclear issues and economics, represent important contributions to the current global effort.
Documents
Terms of reference (pdf)
- Background information / Non-NEA position papers
- Health community guidance documents / Information
- Demand expectations
Related links
High-level Group on the Security of Supply of Medical Radioisotopes (HLG-MR)
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14-15 December 2009 meeting of the High-level Group on the Security of Supply of Medical Radioisotopes (HLG-MR)
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NEA Workshop on Security of Supply of Medical Radioisotopes (29-30 January 2009) - Chair’s Summary
Securing vital supplies of medical radioisotopes 
Press release - 16 December 2009
Nuclear Development Committee (NDC)
Contacts
Last reviewed: 26 February 2010