VZCZCXYZ0000
OO RUEHWEB

DE RUEHC #3002 0432324
ZNR UUUUU ZZH
O R 122320Z FEB 10
FM SECSTATE WASHDC
TO RUEHWR/AMEMBASSY WARSAW IMMEDIATE 0000
INFO RUEHRL/AMEMBASSY BERLIN 0000
RUEHBS/AMEMBASSY BRUSSELS 0000
RUEHFR/AMEMBASSY PARIS 0000
RUEHSA/AMEMBASSY PRETORIA 0000

UNCLAS STATE 013002 
 
SIPDIS 
SENSITIVE 
 
E.O. 12958: N/A 
TAGS: TRGY TBIO PL
SUBJECT: REQUEST FOR EMBASSY WARSAW PARTICIPATION IN A 
POLISH ATOMIC ENERGY AUTHORITY-COVIDIEN EVENT ANNOUNCING 
MO-99 PRODUCTION 
 
REF: A. STATE 113758 
 
Sensitive but Unclassified - please protect accordingly. 
 
¶1. (U) This is an action request for Embassy Warsaw.  See 
paragraph 7. 
 
------- 
SUMMARY 
------- 
 
¶2. (U) The United States imports all of its Mo-99 (a key 
medical isotope) from foreign suppliers, but there is 
currently a worldwide shortage due to various nuclear 
research-reactor shutdowns.  Various international 
organizations are now actively focusing on this issue, 
including the Organisation of Economic Co-operation and 
Development's Nuclear Energy Agency (OECD/NEA) in Paris and 
the IAEA.  As part of their efforts to assist in meeting 
global demand, the Polish Atomic Energy Authority and 
Covidien are planning to announce an agreement to produce 
Mo-99 using the Polish reactor MARIA, in an event taking 
place on February 17, 2010 in Warsaw.  The event planners are 
interested in having the participation and a few remarks from 
the U.S. Ambassador to Poland or the Deputy Chief of Mission 
(DCM).  Washington supports the U.S. Embassy participation at 
the highest level Embassy deems appropriate and feasible. 
 
END SUMMARY. 
 
---------- 
Background 
---------- 
 
¶3. (U) Technetium-99 metastable (Tc-99m) is a crucial 
radioisotope produced from the decay of the medical isotope 
molybdenum-99 (Mo-99).  It is used in about 100,000 nuclear 
diagnostic procedures daily around the globe, including heart 
disease and cancer diagnosis, and studies of organ structure 
and function.  Global supply of Mo-99 is generated primarily 
from the irradiation of enriched-uranium targets in five 
research reactors around the world.  The two largest of those 
reactors, the National Research Universal (NRU) reactor in 
Canada and the High Flux Reactor (HFR) in The Netherlands, 
have experienced technical difficulties over the past two 
years, including a heavy water leak in the main containment 
vessel of the NRU which has required the shutdown of the 
facility until at least the first quarter of 2010.  The HFR 
will be experiencing a 25-week maintenance shutdown beginning 
in February 2010. 
 
¶4. (U) These problems have resulted in severe global Mo-99 
supply shortages with serious consequences for the medical 
community.  OECD/NEA, with U.S. support from DOE/NNSA's GTRI 
program and the U.S. Department of Health and Human Services, 
is now engaging with supplier states and others to address 
this issue, including the OECD/NEA's High Level Group on the 
Security and Supply of Medical Radioisotopes (HLG-MR).  In 
addition to these international coordinating efforts, the USG 
wishes to encourage the adoption of certain mitigating 
measures, especially in CY 2010.  A nonpaper summarizing the 
problem and the USG's views is included in paragraph 9 for 
Post reference. 
 
¶5. (SBU) In an effort to facilitate the implementation of 
alternative measures to alleviate the shortage of Mo-99, the 
President's Science Advisor wrote to the Minister of the 
German Federal Ministry for the Environment, Nature 
Conservation, and Nuclear Safety (REF A).  The letter 
requested Germany,s assistance to secure the regulatory 
approval for the transit through Germany of Mo-99 production 
targets irradiated at the MARIA reactor in Poland.  The 
irradiated targets would be transported to processing 
facilities in The Netherlands to extract Mo-99.  The text of 
the letter is included in paragraph 10 for Post's 
informational purposes only. 
 
¶6. (SBU) The agreement between the Polish Atomic Energy 
Authority and Covidien to produce Mo-99 from the Polish 
reactor MARIA has been concluded.  MARIA will produce an 
estimated 900 6-day Curies of Mo-99 per week.  With the 
approval of the Polish Atomic Energy Authority, an event is 
being planned to announce the agreement on February 17, 2010 
at 2:30 pm, at the Polish Press Agency Press Center in Warsaw 
(6/8 Bracka Street 00-502).  Speakers at the event will 
include the Covidien European President, Vice President and 
other senior officials, senior representatives from the MARIA 
reactor, the Deputy Minister of Health, and Deputy Minister 
of Economy.  The planners of this activity expressed their 
interest in inviting the U.S. Ambassador to Poland or the DCM 
to participate.  The announcement will be preceded by a 
luncheon to begin at 12:30 pm at the London Room of the 
Warsaw Sheraton Hotel (UI. B. Prusa 2, 00-493), to which the 
Embassy representative is also invited.  Washington supports 
the presence of the U.S. Embassy at this event, at the 
highest level Post deems appropriate and feasible.  The 
contributions that the MARIA reactor will make to the global 
community will result in an average of tens of thousands of 
medical-isotope procedures per week that otherwise would not 
be available. 
 
END BACKGROUND 
 
--------------- 
ACTION REQUESTS 
--------------- 
 
¶7. (SBU) Post is requested to participate in the announcement 
event at the highest appropriate level, to inform the POCs in 
paragraph 11 by February 16 whether and at what level it 
intends to participate, and to provide a brief post-event 
reporting cable. Talking points for the event are included in 
paragraph 8. 
 
-------------- 
TALKING POINTS 
-------------- 
 
¶8. (SBU) BEGIN OF TALKING POINTS 
 
-- The United States is concerned about the global shortage 
of Mo-99 and its implications for the health care of millions 
of patients around the world. 
 
-- The United States is currently dependent on the 
international community for its supply of Mo-99. 
 
-- The United States would like to work with partner 
countries to facilitate the implementation of alternative 
measures to alleviate the shortage of Mo-99, and ensure 
continuous supply of this critical medical isotope. 
 
-- The United States also supports international efforts such 
as those being undertaken by the Organisation of Economic 
Co-operation and Development's Nuclear Energy Agency 
(OECD-NEA) and its High Level Working Group on the Security 
of Supply of Medical Radioisotopes (HLG-MR). 
 
-- In that regard, we also support and welcome the planned 
production of irradiated targets at the MARIA reactor, and 
their subsequent processing in The Netherlands to extract 
Mo-99 for delivery to the international community. 
 
-- We commend Poland for their initiatives on behalf of the 
stability of Mo-99 supply, and for the completion and signing 
of this agreement between the Polish Atomic Energy Authority 
and Covidien to produce Mo-99 from MARIA. 
 
-- This initiative illustrates the importance and value of 
close cooperation between relevant stakeholders, including 
government and industry, in achieving the goals of sustained, 
adequate supply of medical isotopes. 
 
-- We also want to thank the German government for efforts 
aimed at facilitating the transit of the Mo-99 targets from 
Poland to The Netherlands. 
 
-- The agreement announced today allows contributions from 
the MARIA reactor to the global community that will result in 
an average of tens of thousands of medical-isotope procedures 
per week that otherwise would not be available. 
 
-- The United States stands in strong support of all 
international efforts to maintain a stable Mo-99 supply for 
the benefit of the global medical community. 
 
-- As we are all aware, there is a delicate balance between 
the objectives of (1) reducing the use of highly enriched 
uranium in research reactors and isotope production 
facilities and (2) maintaining a reliable supply of medical 
isotopes for the medical community. 
 
-- In this light, the United States also praises Poland and 
the MARIA reactor management for their ongoing efforts, in 
cooperation with the Global Threat Reduction Initiative of 
the U.S. Department of Energy, the International Atomic 
Energy Agency, and others in working toward conversion of the 
reactor from highly enriched uranium to low enriched uranium 
fuel as soon feasible. 
 
END OF TALKING POINTS 
 
-------- 
NONPAPER 
-------- 
 
¶9. (U) BEGIN TEXT OF NONPAPER (FOR REFERENCE ONLY) 
 
CONSIDERATIONS REGARDING EXPECTED SHORTAGES OF MOLYBDENUM-99 
IN 2010 
 
The decay product technetium-99 metastable ("Tc-99m") of the 
medical isotope molybdenum-99 (Mo-99) is a crucial 
radioisotope used in 80,000 nuclear diagnostic medical 
procedures performed around the globe every day.  Its primary 
uses include diagnosing heart disease, studying organ 
structure and function, and as a diagnostic in cancer 
treatment.  Tc-99m's very short half-life (6 hours) and 
excellent binding properties make it uniquely suited for a 
large variety of medical procedures.  However, the half-life 
of parent isotope, Mo-99, is also short (66 hours), making it 
impossible to stockpile and requiring the nuclear isotope to 
be produced on a nearly continuous basis. 
 
The world's supply of Mo-99 is generated primarily from the 
irradiation of enriched-uranium targets in only five research 
reactors around the world.  They are the National Research 
Universal (NRU) reactor in Canada, the High Flux Reactor 
(HFR) in The Netherlands, the BR2 reactor in Belgium, the 
OSIRIS reactor in France, and the SAFARI-1 reactor in South 
Africa.  The world's two largest production reactors, the NRU 
and HFR, have experienced technical difficulties and 
shutdowns over the past two years that have caused severe 
global Mo-99 supply shortages and serious impacts to the 
global medical community.  During periods of shortage, an 
estimated 85 percent of U.S. medical facilities have been 
forced to ration and cancel many critical diagnostic 
treatments. 
 
On May 14, 2009, the volatility of the Mo-99 supply was 
further exacerbated when a heavy water leak in the main 
containment vessel of the NRU reactor was discovered, 
requiring the shutdown of the facility for an extended period 
of time that continues today.  Despite intensive efforts to 
restore production, it was announced in August 2009 that the 
reactor will not resume operations until at least April 2010. 
 In addition, the HFR reactor will be experiencing a 25-week 
maintenance shutdown scheduled to begin in February 2010. 
Because the NRU will not resume operations by the time the 
HFR reactor is scheduled to shut down, the availability of 
this important medical isotope will hit critically low levels. 
 
The Organisation of Economic Co-operation and Development's 
Nuclear Energy Agency hosts a High Level Working Group on the 
Security of Supply of Medical Radioisotopes (OECD-NEA 
HLG-MR).  This international working group seeks to engage 
commercial producers and industry groups to promote efficient 
coordination and management of the production and use of 
Mo-99.  The United States and is a member of the OECD-NEA 
HLG-MR. 
 
At the facility level, existing large-scale global producers 
of Mo-99 in Belgium, France, and South Africa have also been 
working to coordinate their operating schedules and increase 
production plans to help mitigate the expected supply 
shortages.  This increased coordination is expected to lessen 
the impact of the expected shortfall.  Nevertheless, the 
supply availability even under the most optimized production 
schedules among the remaining global producers is still 
expected to be no greater than 50 percent of normal if the 
NRU does not resume operations in April as expected.  Crucial 
medical diagnostic procedures all over the world will be 
canceled, delayed, or prescribed using often less-effective 
alternative diagnostic procedures. 
 
The efforts to irradiate targets at the MARIA reactor, 
combined with the remaining global producers optimizing their 
respective operating schedules, are expected to reduce the 
expected supply shortage of this critical medical isotope in 
¶2010. 
 
END TEXT OF NONPAPER 
 
--------------------------------------------- --------- 
LETTER FROM THE PRESIDENT'S SCIENCE ADVISOR TO GERMANY 
--------------------------------------------- --------- 
 
¶10. (SBU) Begin Text of Letter to Germany (for reference only) 
 
The United States and the world depend primarily on the 
operation of five nuclear reactors for the production of 
molybdenum-99 (Mo-99), a critical medical isotope used in 
approximately 80,000 nuclear medical diagnostic procedures 
every day around the globe. To ensure the stable supply of 
Mo-99, the Organisation of Economic Co-operation and 
Development's Nuclear Energy Agency (OECD-NEA) has been 
working to engage commercial producers and industry groups 
internationally in promoting efficient coordination and 
management of Mo-99 production and use through its High Level 
Working Group on the Security of Supply of Medical 
Radioisotopes (HLG-MR). The United States fully support the 
OECD-NEA and its HLG-MR efforts. As a new participant member 
of the OECD-NEA HLG-MR, Germany is to be commended for 
demonstrating a strong commitment to securing the supply of 
this important medical isotope. 
 
The United States is concerned about the supply of Mo-99 
during the impending four-to-six-month maintenance shutdown 
of the HFR reactor in The Netherlands, and the 
still-uncertain restart of the NRU reactor in Canada. 
Beginning in March 2010, the world's supply of this important 
isotope is expected to be drastically reduced unless other 
existing global suppliers can find alternative means of 
production during this time. 
 
One promising alternative to produce Mo-99 during this 
expected shortage is to utilize the MARIA reactor in Poland 
to irradiate the targets used to manufacture this isotope, 
and subsequently the processing facilities in Belgium to 
provide a supply to the world's medical community.  This 
option would require the transit of irradiated targets 
through Germany.  If this alternative could be implemented 
during the maintenance shutdown of the HFR reactor, the 
supply shortage of this critical medical isotope would be 
significantly reduced. 
 
I would like to request your assistance in working within 
your government to help secure the regulatory approval for 
the transit of such medical-isotope production targets 
through Germany for this purpose. 
 
If you would like to discuss these considerations further, I 
would be happy to arrange for a meeting among our respective 
government experts at a mutually convenient time. 
 
Sincerely, 
 
John P. Holdren 
Director 
Office of Science and Technology Policy 
Executive Office of the President of the United States 
 
End Text of Letter to Germany. 
 
----------------- 
POINTS OF CONTACT 
----------------- 
 
¶11. (U) Department thanks Post for its assistance in this 
matter.  Main points of contact for these efforts are: 
DOE/NNSA/NA-21 ) Dr. Parrish Staples (202-586-4042, 
Parrish.Staples@nnsa.doe.gov) and OSTP ) Dr. Tammy Taylor 
(202-456-6086, ttaylor@ostp.eop.gov).  Department POCs are 
Dr. Dan Fenstermacher and Dr. Zaira Nazario (ISN/NESS, 
202-647-2833, fensteda@state.gov, and 202-647-8829, 
nazariozd@state.gov). 
CLINTON