15 November 2017

Africa: Is SA 'Among the Top Six in the World' for Nuclear Medicine Ingredients?

analysis

South Africa's third energy minister for 2017 has high praise for the country's nuclear capabilities. Here's what we know about South Africa's contribution to nuclear medicine.

The day after Minister David Mahlobo was moved from state security to energy, he highlighted South Africa's achievements in nuclear science.

"Nuclear is not only used for those aspects of electricity," Mahlobo said in a radio interview.

"We're actually leading in terms of using nuclear isotopes so that we can be able to do advancements in terms of human sciences in terms of contributing to health. We're actually among the top six in the world."

Asked what Mahlobo was referring to, his spokesman Nomvula Khalo said the minister had been informed about South Africa's nuclear isotope production. She referred Africa Check to the state-owned Nuclear Energy Corporation of South Africa (Necsa).

Necsa operates South Africa's major nuclear research reactor Safari-1, which fired up in 1965. Unlike the Koeberg Power Station close to Cape Town, the Safari-1 reactor on Necsa's Pelindaba campus outside Pretoria does not produce electricity.

It uses nuclear power for research and creating medical radioisotopes, among other things. Radioisotope production falls under the Necsa-subsidiary NTP Radioisotopes.

What is a medical radioisotope? The short answer is that it is a crucial ingredient in diagnosing and treating some types of cancer. (Note: The long answer, which involves chemical element flavours and 66-hour deadlines, is detailed in our box.)

The anatomy of a medical radioisotope

All visible matter in the universe is made up of chemical elements, such as carbon or iron. And these chemical elements often have different varieties, like chocolates in a bag of Quality Streets. They are all chocolate, but have different flavours.

The varieties of chemical elements are called isotopes. An atom's nucleus contains protons (positively charged particles) and neutrons (particles with no charge), and the number of protons defines what the atom is. For example, all varieties of carbon have six protons, but they can have a different number of neutrons.

Sometimes isotopes' nuclei are unstable because they have too many neutrons and so they break down into other atoms. For example, uranium has no stable isotopes and so will always break down into other chemicals, emitting radiation when it does. These radioactive varieties are called radioisotopes.

How are radioactive atoms used in medicine?

"A radioactive dose is given to the patient and the activity in the organ can then be studied either as a two-dimensional picture or, using tomography, as a three-dimensional picture," according to the World Nuclear Organisation.

Unlike uranium-235, which has a half-life of just over 700 million years, a medical radioisotope breaks down quickly.

Radioisotope Molybdenum-99 (Mo-99), for example, is a staple in nuclear medicine. This man-made radioisotope has a half-life of 66 hours before it decays into Technetium-99 (Te-99), which is what gets injected into a patient.

Suppliers sell Mo-99 to hospitals, because Te-99's six-hour half-life makes it logistically difficult to get to the patient in time. This is the most widely used radioisotope in nuclear medicine.

No evidence provided

Necsa's annual report for the 2015/16 financial year states that its NTP subsidiary provided medical radioisotopes to more than 60 countries, with its turnover exceeding R1 billion. But it didn't contain radioisotope and radiopharmaceutical production information.

Head of corporate communications and stakeholder relations at Necsa, Arno van Haght, was unable to provide Africa Check with comparative market figures. However, he claimed that NTP Radioisotopes produces up to 20% of the total annual global demand for the major medical nuclear isotope Mo-99, making it one of the three largest global producers.

The International Atomic Energy Agency's press officer Luciana Viegas said that the agency did not have a breakdown of radioisotope production by country.

The World Nuclear Association states on its website that South Africa is one of the world's six main producers of radioisotopes. The others are Ireland (Mallinckrodt Pharmaceuticals), Europe (IRE), Canada (MDS Nordion), Russia (Isotop-NIIAR) and Australia (ANM). (Note: In 2016, it was announced that Canada would close its Chalk River nuclear reactor, significantly reducing the country's radioisotope output. Production is expected to stop early next year.)

The association further claims a breakdown of production per reactor as follows:

HFR in the Netherlands (40%),

BR-2 in Belgium (20%),

Safari-1 in South Africa (15%),

Opal in Australia (15% increasing to 24% from mid-2018) and

Maria in Poland (5%),

LVR-15 in the Czech Republic (5%).

Asked for clarity on the source of these figures, the association's senior communication manager Jonathan Cobb told Africa Check: "Those figures were added to the [information sheet] a couple of years ago through original research. We have confidence in the veracity of the data, but can't supply a citation."

Conclusion: The claim looks to be correct

Highlighting other uses of nuclear technology, South Africa's new energy minister claimed the country is "among the top six in the world" for medical radioisotopes production.

The state-owned company which produces these radioisotopes was unable to provide figures showing where South Africa ranks. The World Nuclear Association claims on its website that South Africa is in the top three for the production of the major medical nuclear isotope Mo-99, but doesn't explain how it was determined.

Without a closer look at the books, we have to rate this claim unproven.

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