Canadian doctors have slammed the federal Conservative government for the isotope shortage plaguing the nation. The shortage has forced the cancellation of thousands of medical tests across the country. The world at large too could begin to feel the pinch before long.
Ottawa mishandled the medical isotopes crisis, the Canadian Medical Association's outgoing president Dr. Robert Ouellet charged Wednesday.
The National Research Universal nuclear reactor at Chalk River, Ontario — normally a major world supplier of medical isotopes — has been out of service since mid-May and has seen its repair date postponed three times already. It is feared the reactor may never be restarted, leaving Canada without a facility to produce isotopes used in a variety of diagnostic medical tests.
Ontario reactor is the biggest single source in the world of the isotope cobalt-60, which has been used in cancer treatment for more than half a century. The reactor produces enough isotopes to treat more than 76,000 people a day — more than 20 million a year.
Actually it was scheduled to be decommissioned in 2005 and replaced by two new reactors called Maple 1 and Maple 2.
Conceived in the early-1990s, the Maples (which stands for Multipurpose Applied Physics Lattice Experiment) were supposed to start generating isotope feedstock in 2000 and 2001. But as a result of management, engineering and construction flaws, they never worked well enough to get regulatory approval.
In May 2008, the Atomic Energy of Canada Ltd (AECL) scrapped the Maple projects altogether, putting more pressure on NRU to continue to supply the bulk of the isotopes.
For Canada's physicians and patients, the shutdown of the NRU reactor and the resulting prolonged shortage of medical isotopes, is a serious medical issue that directly affects the health of Canadians and the sustainability of the health care system, the outgoing president warned.
"The federal government didn't play the role it should have played there," he said after the association passed numerous motions calling upon the government to dive back into the isotope business.
The association insisted that the country should retain a leading role in providing medical isotopes for the world,.
One of the motions expressed appreciation and admiration for the health-care workers across the country who have been trying to serve patients during the isotope shortage, declaring the CMA is "deeply troubled that the prolonged and unpredictable shortage of medical isotopes continues to compromise patient care."
"There was a warning a year-end-a-half ago when the Chalk River reactor went wrong. They didn't provide any views on what will come in the future. And this reactor is 53 years old," Dr. Robert Ouellet said.
The government's decisions on reactors have been made "for financial reasons," Ouellet noted, adding it did not fully consider the effects on patient care.
"The federal government must be made accountable for this," Ouellet told delegates earlier in French. "They lacked foresight, and of course right now there's a shortage, and there will be additional costs for everyone."
Doctors are also demanding the government conduct "open, meaningful and ongoing consultations with nuclear medicine physicians" and their associations on all federal decisions affecting the supply of medical isotopes.
The shortage has driven up the price of existing isotopes, a blow to cash-strapped hospitals and clinics. Ouellet said if provincial governments can't pay, the federal government should step in, because it is responsible for the problem.
Apart from the Canada, there are four other major producers of isotopes in the world, Netherlands, Belgium, France and South Africa. Those reactors too are at least 40 years old and showing their age.
The International Atomic Energy Agency says while improvements to some existing facilities around the world are in the works, no new plants have been commissioned for years. The agency notes that it would take years to get from the construction phase to isotope production at any reactor currently on the drawing board.