Political Meltdown: For decades, Canada has been a world leader in the production of medical isotopes. Why is the government dumping the program?
March 3, 2012
IF YOU’VE EVER had a cardiac perfusion test to see how the blood was flowing in and around your heart or a bone scan to determine whether your cancer had metastasized, then you, like some thirty million people around the globe every year, have been the beneficiary of medical isotopes. What makes these unstable atoms so handy is that they can be injected, swallowed, or inhaled, and once inside the body they emit radiation from predetermined places. From there, their radioactivity can be used to kill off cancer cells or, far more often, to etch a detailed picture of your innards.
Canada is the world’s largest single producer of medical isotopes. In fact, they were practically invented here. Most of the world’s isotopes are made inside nuclear reactors. In Canada, they’re produced in one in particular, at the Chalk River Laboratories nuclear facility, northwest of Ottawa. And when, in November 2007, that reactor was unexpectedly shut down, large parts of the world faced their first real “isotope crisis.” Their entire supply had suddenly been cut off.
This was when isotopes punctured the national consciousness. Doctors offered daily updates like sports scores about the thousands of patients who would be forced to forgo tests and what dire consequences this might have. The Canadian Nuclear Safety Commission said the reactor, which is owned by Atomic Energy of Canada Limited, couldn’t be turned back on until a coolant pump was installed. Then parliamentarians stuck their noses in and voted unanimously to restart the reactor without the pump, overruling the nuclear regulator.
The government carefully framed the crisis as a medical calamity brought on by an overly persnickety regulator. The reactor was restarted in mid-December, and soon the hysteria died down. On the surface, everything went back to normal. But just a few months later,AECL abandoned two new nuclear reactors that had been built exclusively to produce medical isotopes. A year after that, Prime Minister Stephen Harper declared that Canada was getting out of the isotope business altogether. “For whatever reason,” he said, “Atomic Energy was not able to make that project work.”
To many of us who’d been following the saga, that announcement felt like craziness. We were turning our backs on one of the best gigs going. Demand for isotopes is growing, and it’s a niche business: churning them out in mass volume requires a reactor. Perhaps best of all, isotopes seem distinctly Canadian — a feel-good by-product of an unpopular technology, a sort of peacekeeper of the nuclear world.
But in time, what I learned is that our isotope fiasco wasn’t really the result of an overly strict regulator or incompetent engineers. The new reactors were shuttered, and the industry was dispensed with, because it was far from being the lucrative money spinner many presumed it to be, and Harper knew the truth: that isotopes were hemorrhaging millions of dollars from the public coffers every month. It turns out that the lust to privatize federal assets some quarter century ago drove us to make a deal so bad that it put Canada’s future producing isotopes in jeopardy. A deal so bad that it made better economic sense to forfeit the whole industry than to pony up and fix it.
THE IDEA THAT radioactive materials could treat disease was pioneered in Europe and the US around the turn of the twentieth century, when radium, a product of uranium and thorium breakdown, showed promise as a tumour-fighting agent. Canada’s isotope reign began a little later, in 1947, with the construction of the National Research Experimental reactor (NRX for short), in Chalk River, which was for a time the most powerful and versatile reactor in the world. Soon after its completion, the NRX was shipping iodine-131 to various places around the world to treat thyroid cancer. It was Canadian researchers at the National Research Council’s Montreal laboratory who saw that cobalt-60 could be used to fight cancerous tumours; and doctors in London, Ontario, who were the first, in 1951, to treat a patient with it. Later, sales of our cobalt-60 beam therapy units pushed us to the forefront of nuclear medical technology. Profits from those sales helped finance research into further uses for isotopes, including sterilizing medical devices through irradiation.
These days, the most common medical isotope, used in about 80 percent of all nuclear medicine procedures, is technetium-99m. It starts out as highly enriched uranium, which is put inside a reactor, where it undergoes nuclear fission and produces a by-product called molybdenum-99 (pet named moly-99), which is extracted and purified and then placed in a lead canister called a generator.
Then it’s a race against time. The stuff starts to decay immediately. As it does, it turns into technetium-99m — the isotope we want. Moly-99 has a half-life of sixty-six hours, which means that within about three days half of it will have been transformed. Technetium-99m has a half-life of a mere six hours. Canisters of moly-99 are sped to a nearby airport, loaded onto a chartered aircraft, flown to an airfield near a hospital or a pharmaceutical company, and manufactured into the substance that will be used in medical tests and treatments. In just over a week, there’s no product left, so isotope manufacturers have to run a very tight ship.
By all accounts, Canadians did pretty well in the early years of producing and selling isotopes. According to the 2000 book Isotopes and Innovation: MDS Nordion’s First 50 Years, 1946–1996, by Paul Litt, 1980 revenues for AECL’s Radiochemical Company, which dealt with the isotope side of the business, had shot up by 30 percent for the second year in a row. Total sales were almost $49 million, $3.4 million of which was profit. Better yet, by 1982 the US Food and Drug Administration had given the nod to a whole new class of drugs known as radiopharmaceuticals, which utilize radioactive isotopes, and the future looked good.
BRIAN MULRONEY CAME to power in September 1984, with the most elected seats in Canadian history. He campaigned as an anti-patronage crusader and a debt slayer. (During the previous Liberal regime, the debt had ballooned from around $32 billion to more than $200 billion.) And, throwing a bone to the right wing, he also promised to sell off Crown assets wherever possible. It didn’t take long before his eye fell on AECL’s profitable radiochemical division.
According to Litt’s book, the 1985 budget pledged that the “operation of AECL will be rationalized and profitable activities commercialized.” Throughout its thirty-three-year history, there hadn’t been many profitable activities within AECL. The agency consisted mainly of physicists and engineers doing experiments and designing complex nuclear reactors, mostly to produce energy. If anything, the government saw AECL as a big money pit.
So in September 1988, the isotope division was wrested away from its parent. Like a child up for adoption, it was given a new name, Nordion International Inc., and a glowing spec sheet, then moved into the orphanage of the Canada Development Investment Corporation, where all Crown corporations awaiting new owners were sent to bide their time.
In the push to privatize, Fishery Products International Ltd., Air Canada, and Petro-Canada would all leave public hands by the end of 1991. But compared to airlines and oil companies, the isotope business was a tangled mess. The central issue was that it relied on nuclear reactors that would remain in public hands. AECL would continue to operate and maintain the reactors, and its workers would extract the raw isotopes; only the processing, sales, and distribution part of the business was to be sold. That was problematic for the seller as well as for potential buyers. While AECL produced the isotopes, it wouldn’t receive any of the profits…