Is the U.S. “Offer” to Iran on Medical Isotopes a Pretext for More Coercive Action?

Earlier this week, journalists highlighted U.S. Deputy Secretary of Energy Dan Poneman’s statement that the Obama Administration had “offered to facilitate Iran’s procurement through the world markets of the medical isotopes its citizens need,” but that “Iran’s leaders apparently prefer to reject the most responsible, cost effective, and timely options to ensure access to medical isotopes in order to advance their nuclear program.”  Without question, they went on to quote Poneman that Iran’s “announcement last month that it will start enriching uranium to nearly 20 percent U-235 is a transparent ploy.  It has nothing to do with trying to help Iranian cancer patients who will need medical isotopes later this year.”

Poneman’s statements picked up on themes previously articulated — also without question by journalists — by Glyn Davies, the U.S. ambassador to the International Atomic Energy Agency.  Davies asked rhetorically, “Why is Tehran gambling with the health and lives of 850,000 Iranian cancer patients in pursuit of ever more dangerous nuclear technology,” noting that “this move is callous and chilling.”  Davies asserted to the Associated Press that, “to address the humanitarian needs of Iran’s people, we are prepared to facilitate Iran’s procurement of medical isotopes from third-country sources,” arguing that this U.S. proposal represented a “faster, cheaper, and more responsible alternative than enriching to 20 percent.”  In an interview this month with CNN’s Christiane Ammanpour, Davies reiterated that

there’s an international market for medical isotopes.  There are ways for Iran to purchase them if they need to purchase them, once this research reactor’s fuel runs out.  That’s a far safer way to proceed than for Iran, which has never before manufactured fuel for any sort of nuclear reactor, to try to do it on its own on a rush basis.

But journalists should have asked Poneman and Davies basic questions: Will or can the U.S. sell Iran the medical isotopes it needs?  If not, why not?  Who else in the international community will or can sell Iran the medical isotopes it needs?  And, the journalists could have done some basic research themselves.  They would have turned up a fundamental obstacle to implementing the Obama Administration’s “offer” — there is currently, and has been for some time, a worldwide shortage of medical isotopes, which is going to get even more acute in the foreseeable future.

Around the world, there are five reactors that commercially produce Molybdenum-99, the basic source material for one of the world’s most widely used medical isotopes.  Currently, Iran imports all of the Molybdenum-99 it uses; about half of that is wasted in transit as the Molybdenum decays, a waste which could be avoided if the Molybdenum was produced locally.  Although Iran has completed construction of an installation for producing radioisotopes at the Tehran Research Reactor (TRR), it needs to refuel the TRR soon in order to proceed with plans for domestic production of medical isotopes.

For a useful overview of Iran’s plans for medical isotope production — which implicitly calls into question the accuracy of statements by Poneman and Davies about the cost effectiveness for Iran of importing medical isotopes as opposed to producing them domestically — see this first-rate analysis by Geoffrey Forden on  This analysis concludes:

Iran has developed plans to use naturally occurring uranium as a “target” for producing an important medical diagnostic isotope of molybdenum, an isotope whose decay product can be used to scan for cancers in bone, heart, lung, and kidney.  Iran already imports a sizable quantity of this pharmacological radionuclide but producing it indigenously would not only save Iran a considerable amount of money each year, much more than it would pay for the fuel for the reactor it would use to produce it, but also allow a more efficient use of this short lived isotope by preventing the decay of nearly half of the amount bought before it even reached the patients. . . .

The real benefit to Iran for completing this deal, however, will not be the savings of a few million dollars or even the savings of nearly half the imported diagnostic radioisotopes from unavoidable wastage due to decays during shipment.  The real savings will be the foot up Iran gets in its health care from starting to develop its own nuclear medicine industry.  The discrepancy between the use of diagnostic isotopes in Iran and the developed world can, and should, be dramatically reduced; as it should for the entire world.

None of the reactors that commercially produce Molybdenum is in the United States.  One of the five reactors, in Canada, has been off line since last year; a second, in the Netherlands, is about to go off line.  These two reactors supply more than 80 percent of the molybdenum used in the United States.  The reduction of supply from the Canadian reactor has already had a significant impact on medical practice in the United States; a survey of more than 700 American hospitals conducted last year by the Society for Nuclear Medicine found that 80 percent of these hospitals were delaying procedures for cancer and cardiac patients because of an isotope shortage.  The Society of Nuclear Imaging issued a statement on Thursday saying that, with the Dutch reactor also going off line, the U.S. medical community will experience “one of the most significant disruptions ever” in the supply of a molybdenum derivative that is normally used in 14 million nuclear medicine tests in the United States each year.  While arrangements are being made to bring molybdenum produced at a reactor in Poland onto international markets for medical isotopes, nuclear medicine professionals say that this will only marginally alleviate the ongoing shortage.

So where, exactly, is Iran supposed to buy new quantities of medical isotopes, and how, exactly, would the United States help to facilitate such purchases, when American medical facilities are not able to procure sufficient quantities of the relevant materials?  It is truly disappointing that journalists who covered Poneman’s remarks earlier this week and Davies’ previous comments on the subject failed to ask these most basic and obvious follow-up questions.  But that would have required them to have learned from their reporting failures in the run-up to the U.S. invasion of Iraq and to engage in real reporting about an Iran-related issue.

We have written several times on about the back-and-forth between Washington and Tehran about proposals for refueling the Tehran Research Reactor (TRR).  As we have argued, the Obama Administration has unnecessarily taken what should be a straightforward technical issue — how Iran can secure new fuel for the TRR without exacerbating international concerns about the perceived proliferation risks of its nuclear activities — and turned it into a highly politicized effort to forestall the theoretical possibility of an Iranian “breakout” capability for a year, during which the Obama Administration would try to sort out the internal inconsistencies in/unresolved questions about its own Iran policy.

Unsurprisingly, as long as basic questions like the “acceptability” of enrichment on Iranian soil are not resolved, Iran is unwilling to accept, without some modifications, the so-called ElBaradei proposal for refueling the TRR via a “swap” of new fuel for a large part of Iran’s current stockpile of low-enriched uranium.  In his remarks earlier this week, Poneman said that, with the ElBaradei proposal, the United States and other governments “responded positively and creatively to Tehran’s initial request for assistance in refueling the Tehran Research Reactor with a fair and balanced proposal designed to meet Iran’s humanitarian needs for medical isotopes and being to build mutual trust and confidence.”

But Tehran had originally asked the IAEA to help it purchase new fuel for the reactor, in a manner thoroughly compliant with Iran’s safeguards obligations.  From Tehran’s perspective, the international community’s willingness to move ahead with such a transaction would have built Iranian trust and confidence in pledges by the United States and other countries to help the Islamic Republic enjoy the full benefits of peaceful nuclear technology — including the capability to produce medical isotopes in Iran.

So, now, with their too-clever-by-half gambit having failed, senior Obama Administration officials are engaged in a concerted effort to win a “public diplomacy” battle with Tehran over the issue.  In that effort, the charge that Iran is cavalierly indifferent to the fate of its cancer patients has apparently been deemed a valuable talking point.  But, is it just a talking point, or is it another pretext for the Obama Administration to take America’s Iran policy in more coercive directions?

Flynt Leverett directs the Iran Project at the New America Foundation, where he is also a Senior Research Fellow.  Additionally, he teaches at Pennsylvania State University’s School of International Affairs.  Hillary Mann Leverett is CEO of Strategic Energy and Global Analysis (STRATEGA), a political risk consultancy.  In September 2010, she will also take up an appointment as Senior Lecturer and Senior Research Fellow at Yale University’s Jackson Institute for Global Affairs.  This article was first published in The Race for Iran on 19 March 2010 under a Creative Commons license.

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