Cablegate: Letters From the President's Science Advisor To

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

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LETTERS FROM THE PRESIDENT'S SCIENCE ADVISOR
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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
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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

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