VZCZCXYZ0007
OO RUEHWEB

DE RUEHC #3758 3090544
ZNR UUUUU ZZH
O 041443Z NOV 09
FM SECSTATE WASHDC
TO RUEHRL/AMEMBASSY BERLIN IMMEDIATE 4272-4276
RUEHBY/AMEMBASSY CANBERRA IMMEDIATE 5624-5628
RUEHFR/AMEMBASSY PARIS IMMEDIATE 6981-6985
RUEHSA/AMEMBASSY PRETORIA IMMEDIATE 6973-6977
INFO RUEHUNV/USMISSION UNVIE VIENNA IMMEDIATE 5705-5709

UNCLAS STATE 113758 
 
SENSITIVE 
 
C O R R E C T E D   C O P Y (SENSITIVE CAPTION ADDED) 
 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: TRGY TBIO AS FR GM SF
SUBJECT: LETTERS FROM THE PRESIDENT'S SCIENCE ADVISOR TO 
KEY COUNTRIES PRODUCING THE MEDICAL ISOTOPE MO-99 
 
Sensitive but unclassified - please protect accordingly. 
¶1. (U) This is an action request for Posts Canberra, Paris, 
Berlin, and Pretoria.  See paragraph 4. 
 
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SUMMARY 
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¶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.  In addition to those efforts, the USG would like 
to reach out to several of the supplier countries in 
particular to ask for their collaboration in working to 
maximize Mo-99 production during 2010 and find means to 
ensure the stable supply of this important medical isotope in 
the longer run as well.  Letters from the President's Science 
Advisor are included in paragraphs 6, 7, 8 and 9 for delivery 
by each of the action posts to appropriate Ministers, at 
Posts' earliest opportunity.  END SUMMARY. 
 
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Background 
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¶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 four-to-six month maintenance shutdown 
during the first quarter of 2010.  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, 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. 
 
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ACTION REQUESTS 
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¶4. (SBU) For Canberra:  Post is requested to deliver the 
letter in paragraph 6 to the Australian Minister of Resources 
and Energy. 
 
For Paris:  Post is requested to deliver the letter in 
paragraph 7 to the Chairman of the Commissariat  l'nergie 
Atomique (CEA). 
 
For Berlin:  Post is requested to deliver the letter in 
paragraph 8 to the appropriate Minister of the Federal 
Ministry for the Environment, Nature Conservation, and 
Nuclear Safety. 
 
For Pretoria:  Post is requested to deliver the letter in 
paragraph 9 to the Minister of Energy. 
 
In each case, the nonpaper at paragraph 5 should be included 
with the delivery and may be drawn on for points if in-person 
delivery is possible or appropriate.  In addition, a courtesy 
copy of the letter and nonpaper may be sent to appropriate 
senior staff member(s) in the identified ministry and, if 
embassy judges appropriate, to senior staff in any other 
directly-involved agency or organization. 
 
Please report the results of your engagement and any 
preliminary reactions by November 9, slugging response to 
Dept of Energy Washington DC and to ISN/NESS. 
 
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NONPAPER 
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¶5. (U) BEGIN TEXT OF NONPAPER 
 
 
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 approximately 80% of roughly 100,000 
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 earlier than the first 
quarter of calendar year 2010.  In addition, the HFR reactor 
will be experiencing a four-to-six month maintenance shutdown 
to repair a corrosion problem in its primary cooling system. 
This necessary outage is scheduled to begin no later than 
March 1, 2010.  If the NRU is unable to resume operations by 
that time, 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 each of the countries in this 
cable are members 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.  If coordination is successful, it will help to 
lessen the impact of the expected shortfall, particularly if 
the NRU is unable to resume operations in 2010. 
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.  Crucial medical diagnostic procedures all over 
the world will be canceled, delayed, or prescribed using 
often less-effective alternative diagnostic procedures. 
 
One option that has already been raised informally in 
international discussions to help bolster the production of 
nuclear medical isotopes during the 2010 shortage would be to 
delay the routine five-to-six month maintenance shutdown of 
the OSIRIS reactor in France as long as possible.  An 
additional alternative would be to utilize the MARIA research 
reactor in Poland for irradiation of targets, ship the 
targets through Germany, and process the targets in Belgian 
facilities to extract the Mo-99 for distribution.  Each of 
these options, if combined with the remaining global 
producers, optimizing their respective operating schedules, 
could significantly reduce the expected supply shortage of 
this critical medical isotope in 2010. 
 
END TEXT OF NONPAPER 
 
-------------------------------------------- 
LETTERS FROM THE PRESIDENT'S SCIENCE ADVISOR 
-------------------------------------------- 
 
¶6. (SBU) BEGIN TEXT OF LETTER TO AUSTRALIA 
 
The United States would like to recognize and thank the 
Australian government for demonstrating a commitment to 
ensure the stability and increased availability of the global 
supply of the critical medical isotope molybdenum-99 (Mo-99). 
 
 
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 global 
suppliers are able to increase their production levels. 
Currently in the final stages of commissioning, the OPAL 
facility, operated by the Australian Nuclear Science and 
Technology Organisation (ANSTO), will be one of the few 
additional sources of Mo-99 available to the world. 
 
The United States fully supports the Organisation of Economic 
Co-operation and Development,s Nuclear Energy Agency 
(OECD-NEA) and its efforts 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). As a participating 
member of the OECD-NEA HLG-MR, Australia is to be commended 
for demonstrating a strong commitment to securing the supply 
of this important medical isotope. 
 
To help facilitate these efforts, I would like to request 
your assistance in ensuring that regulatory approvals for the 
OPAL facility will be completed as quickly as is safely 
possible, in order to expedite ANSTO's ability to export 
Mo-99 into the global market.  ANSTO's contribution, in 
coordination with the other key suppliers, to maximize the 
production of Mo-99 during 2010 would help to ensure the 
availability of this critical medical isotope.  The medical 
diagnostics of millions of people around the world depend on 
the coordinated operation of the few available Mo-99 
producing facilities, including the Australian OPAL facility. 
 
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 AUSTRALIA 
 
¶7. (SBU) BEGIN TEXT OF LETTER TO FRANCE 
 
The United States would like to recognize and thank the 
Commissariat  l'nergie Atomique (CEA) for demonstrating a 
commitment to the stable supply of the medical isotope 
molybdenum-99 (Mo-99). 
 
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 Petten, 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 are able to increase, or at least 
maintain, production during this time.  Mo-99 from the OSIRIS 
reactor is one of the few remaining sources available to the 
world. 
 
The United States fully supports the Organisation of Economic 
Co-operation and Development,s Nuclear Energy Agency 
(OECD-NEA) and its efforts 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). As a participating 
member of the OECD-NEA HLG-MR, France is to be commended for 
demonstrating a strong commitment to securing the supply of 
this important medical isotope. 
 
To help facilitate these efforts, I would like to request 
your assistance in ensuring that the OSIRIS facility will 
remain in operation as much as possible to produce Mo-99 
during 2010.  Although I understand that this facility is 
scheduled to shut down for routine maintenance or upgrades 
beginning in April 2010, I would like to know whether this 
shutdown could be safely delayed in consideration of the 
important medical service that this facility provides to the 
global community.  The medical diagnostics of millions of 
people around the world will depend on the coordinated 
operation of the few available Mo-99 production facilities, 
including the OSIRIS reactor. 
 
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 FRANCE 
 
¶8. (SBU) BEGIN TEXT OF LETTER TO GERMANY 
 
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 100,000 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 
 
¶9. (SBU) BEGIN TEXT OF LETTER TO THE REPUBLIC OF SOUTH AFRICA 
 
The United States would like to recognize and thank the 
Republic of South Africa for demonstrating a commitment to 
ensure the stability and increased availability of the global 
supply of the critical medical isotope molybdenum-99 (Mo-99). 
 
 
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 are able to increase, or at least maintain, 
their production levels.  Mo-99 supplied by NTP Radioisotopes 
and produced from the SAFARI reactor, operated by the South 
African Nuclear Energy Corporation (NECSA), is one of the few 
sources available to the world. 
 
The United States fully supports the Organisation of Economic 
Co-operation and Development,s Nuclear Energy Agency 
(OECD-NEA) and its efforts 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). As a participating 
member of the OECD-NEA HLG-MR, South Africa is to be 
commended for demonstrating a strong commitment to securing 
the supply of this important medical isotope. 
 
To help facilitate these efforts, I would like to request 
your assistance in ensuring that South Africa will continue 
to produce Mo-99 at an increased rate and will coordinate 
with the other key suppliers to maximize the production of 
Mo-99 during 2010.  The medical diagnostics of millions of 
people around the world depend on the coordinated operation 
of the few remaining Mo-99 producing facilities, including 
the facility in South Africa. 
 
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 THE REPUBLIC OF SOUTH AFRICA 
 
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POINTS OF CONTACT 
----------------- 
 
¶10. (U) Department thanks all Posts for their 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