A coordinated reserve and shared schedule for the world's medical isotope reactors
A handful of ageing research reactors make most cancer isotopes. Coordinating their maintenance and funding reserve capacity would prevent the shortages that stop treatments.
Lutetium-177, iodine-131 and molybdenum-99 depend on a few research reactors (HFR Petten, BR2, MARIA, SAFARI-1, OPAL, several in Russia and the US), most over 50 years old. The OECD Nuclear Energy Agency's High-Level Group on Medical Radioisotopes coordinated molybdenum-99 after the 2009-10 crisis. The proposal is to extend that model formally to therapeutic isotopes: shared outage scheduling, an agreed reserve capacity margin funded by a per-dose levy, and public co-financing of the next generation of producers (PALLAS in the Netherlands, accelerator-based SHINE, new irradiation positions in existing reactors).
- Manufacturing cost and time for living and radioactive medicines · Cell therapies take weeks to make for one patient and cost hundreds of thousands of dollars. Isotopes run short.
- Most of the world has almost no cancer care · Seven in ten cancer deaths happen in low- and middle-income countries, where radiotherapy, pathology, surgery and drugs are scarce.