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 a 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 www.armscontrolwonk.com.  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 earlier today 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 www.TheRaceForIran.com 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 and Hillary Mann Leverett

 

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

  1. Eric A. Brill says:

    Alan,

    Thanks. I think Flynt and Hillary’s piece was especially valuable because it clearly explained just how short of these isotopes the world is. Iran’s making them would be good for all of us, not just Iran.

    Flynt and Hillary’s piece also made me recognize that my earlier suggestion — that Iran proceed as it has been but be prepared just to purchase isotopes if the opportunity actually arises — was not the right approach, at least in the long-term. That suggestion still is the best course for Iran, I believe, if it’s just limited to fuel plates rather than the isotopes themselves — i.e. Iran could offer to swap its 20% fuel (not just LEU) for 20% fuel plates. In the very short-term, Iran might also agree to buy isotopes (assuming they’re really offered), but it would need to be very careful that the US not get away with what it almost certainly would try to get away with in that event: an insistence that Iran do the same thing in the future. If I were Iran, I’d be quite concerned that buying isotopes this time, and then insisting on making its own next time, would be (loudly) mischaracterized by the US as very suspicious behavior.

    One way or another, Iran has to preserve its long-term practical ability to keep running its TRR to make its own isotopes. There is simply no way to stockpile them, and that means there is no way to assure supply other than by making them itself.

    I think it was Jon Harrison who made this point — the contributions of everyone on this site really do help to sharpen one’s thinking about these issues.

  2. Alan says:

    Eric – I agree with your post below. It does assume of course that the US succeeds in spinning the argument that way, and that is something I think they will struggle with. Maybe the average Joe in the US might swallow it, but in diplomatic circles I suspect it will be a big loser. The Non-Aligned Movement already appears to be on Iran’s side over the IAEA inspections, and the TRR issue is little more than a crass obstruction of a country’s sovereign right to make nothing more than medical products. If the big game here is to bring about sanctions, it strikes me that this would not be the way to get an international consensus for it.

    Also, I think Iranian scientists have invested a lot of time, brainpower and money in developing these isotope production techniques, right at a time when the world is desperate for more of them. It just looks petty to try to take it all away, not to mention cutting off your nose to spite your face. In any case, it would be very short-sighted because sooner or later Iran will be fuelling the TRR themselves if we don’t agree to help them.

  3. Eric A. Brill says:

    Fahad,

    “I do not think that they are able to enrich to 20% without destroying their centrifuges in Natanz.”

    What difference does it make whether the centrifuge is running, say, .7% uranium or, say, 10% uranium? It’s all in a hexafluoride gas form either way, isn’t it? If anything, I would think the higher concentration would be easier on the centrifuges since it contains more U-235, less U-238, so it’s marginally lighter.

  4. Fahad says:

    Liz, why should the IAEA state it? Read this: http://www.armscontrolwonk.com/2505/reading-mark-hibbs-in-washington

    Cyrus, what has been further enriched is minimal amounts. The problem of manufacturing the fuel rods persists. They are bluffing.

  5. Eric A. Brill says:

    The ArmsControlWonk piece cited by others (http://www.armscontrolwonk.com/2492/a-primer-on-irans-medical-reactor) was quite useful. Three points in particular struck me:

    1. The “transport delay” argument strikes me as correct but not strong.

    This argument is that, because medical radioisotopes have such a short half-life, requiring Iran to purchase them from foreign sources is wasteful and expensive because half of what it buys will have decayed by the time they can be transported to Iran for use. All true, but apparently overstated, and not likely to persuade the West even if it is not. According to the ArmsControlWonk piece, the Technetium-99m (99mTc) actually used for medical diagnostics has a 6-hour half-life. But molybdenum 99 (99Mo), the more stable material that effectively “warehouses” the 99mTc while it is being transported or stored, has a half-life ten times as long – 60 hours. So if a hospital in, say, Mashhad, needs medical radioisotopes, it’s maybe a 5-hour plane flight from a Russian reactor, compared to a one-hour flight from Tehran. Still some waste, to be sure, but not significant. If this “transport delay” concern were really that big a deal, after all, there probably would be a reactor in Japan to make medical radioisotopes. It’s a very long flight to Tokyo from any of the world’s six reactors (in Europe, Canada and South Africa) that make medical radioisotopes. The US undoubtedly would raise this “If it’s good enough for Japan…” counter-argument if the “transport delay” argument were pressed very hard.

    2. The “It would save Iran money” argument strikes me as correct but not worth making.

    This argument, in a nutshell, is that it would be less expensive for Iran to produce its own medical radioisotopes, and the fuel used to run the reactor that makes them, than it would be for Iran to buy from foreign sources – in part because of the “transport delay” factor discussed above, but for several other reasons as well. Again, probably true, but I confidently predict the Western reaction to this argument essentially will be “Are you kidding, or what?” I can just imagine a Monday morning meeting at the State Department: “OK, now I need a volunteer to go up to the Hill and explain to some Senate staffers that we should let Iran refine uranium to 4 times its present purity so that it can use the stuff to run a reactor that makes medical radioisotopes because that will save Iran a few million bucks a year. Volunteers? Nobody? Bill, how about you? Come on – you’re due to retire in a few months anyway.” In other words, a wonderful argument but either (1) Iran gets to make the decision, in which case it doesn’t need to make this argument or any other argument; or (2) Iran doesn’t get to make the decision, in which case whoever presents this argument to the decision-makers will not get halfway through the first sentence before his audience bursts into uncontrollable laughter.

    This does not mean, of course, that this “money-saving” argument (and the “transport delay” argument that is really part of this larger “money-saving” argument) should not be taken into account by Iran itself if Iran decides, as I think it should, to press forward with domestic production of medical radioisotopes for the more compelling reasons discussed below.

    3. The “dependable supply” argument strikes me as compelling because of the short half-life of Molybdenum 99, and so Iran, long-term, should do all it can to avoid the “buy foreign” alternative.

    Though short-term tactical considerations might require purchasing medical radioisotopes from foreign sources, I can see after reading the ArmsControlWonk piece that Iran really has no long-term choice but to press forward with its program to produce medical radioisotopes domestically. While the “transport delay” argument may be less strong than some believe (because 99Mo’s half-life is long enough that a longer plane flight won’t matter all that much), a 60-hour half-life nevertheless is far too short to permit any “stockpiling” of medical radioisotopes in Iran. The time span between the making of a medical radioisotope and the use of that medical radioisotope is inevitably short, and so Iran must control that time span. If Iran must call up, say, Russia, and order some medical radioisotopes, it must count on Russia being in a good mood that day. If Russia is not, and no other supplier of medical radioisotopes is in a good mood that day either, Iran will be out of luck. It can’t avoid this problem by stocking up well in advance, since the medical radioisotopes would decay quickly while sitting on the shelf in Iran. Iran can avoid the problem only by controlling the timing of when those medical radioisotopes are made, and it can only control that timing if it is making them itself. (The same argument applies to the 20% fuel used to run the reactors that produce the medical radioisotopes, though the argument is not quite so forceful in that context because the reactor fuel has a much longer half-life than 99Mo, so some “stockpiling” might be feasible.)

    The rough equivalent in the petroleum world would be this. Assume that (1) the US is about to run out of gasoline, its strategic petroleum reserve consists of three quarts of motor oil and a half-empty can of lighter fluid, and it has no facility that can produce gasoline from crude; (2) it wouldn’t help even if the US’ gasoline reserves were a thousand times greater because gasoline decays and becomes useless within a matter of days or weeks; (3) the few suppliers of gasoline to the US include several countries that have been saying nasty things about the US lately; and (4) the US does not have the military power to blow those suppliers back to the Stone Age if they even think about turning off the tap – in fact, those suppliers, or their friends, could instead do that to the US, on a moment’s notice. Would the US feel that its supply of gasoline was secure merely because its suppliers were saying “Don’t worry; you can always buy it from us.”?

    That’s essentially Iran’s situation with respect to medical radioisotopes. Thus, while short-term diplomatic bobbing and weaving may call for Iran to purchase medical radioisotopes from foreign sources, it cannot afford to let purchasing become a permanent substitute for domestic production of medical radioisotopes. It’s got to make its own medical radioisotopes so that it controls the time span between making and use; the “half-life clock” ticks very fast during that time frame.

    This means that Iran should (1) continue to refine uranium up to 20%; (2) continue to develop the capability to make its own fuel plates for the TRR; and (3) if and when it strikes some near-term deal to buy medical radioisotopes from foreign sources (which might require that it swap or sell some or all of the 20% fuel it’s refined in the meantime), make clear that it nonetheless intends to press on with its domestic program to refine uranium, make fuel plates and manufacture its own medical radioisotopes (which, it should add, it will be glad to sell to others as well).

    Needless to say, that will not be well-received by Western countries, but Iran has little choice but to hold firm on this.

  6. Cyrus says:

    The quality of reporting on Iran by Poneman and Davies (stenography is a better word) is generally indicative of the reporting by the US media in general. For example, as Dr. Sick posted on his blog Gary’s Choices, the NY Times recently ran a front-page article about how Iran was moving its uranium stock to the surface, then proceeded to promote a bunch of conspiracy theories about that which ultimately rested on the notioj that Iran was seeking nukes (according to the NY Times, the IRanians were supposedly “baiting” the Israeli to bomb the uranium stocks so as to justify an Iranian effort to make nukes) when far more prosaic expalantions were available but simply ignored by the reporters. And that’s just one example.

    The truth is that our media, which is supposed to be the “watchdog” over government, proved that it cannot be relied upon to be objective, and despite the rather weak mea culpa by the NY Times, nothing has changed since the Iraq invasion build-up. And, our Congress proved to be totally ineffectual in stopping the rush to war in Iraq too, despite the notion that it was supposed to act as a check on the Executive. Our judicial branch has thus far failed to check the executive too, what with legalized torture and “military commisions” which use “secret evidence” that defense lawyers aren’t allowed to see, tortured confessions, etc. And our vaunted “The People” have shown that they can be easily misled too (how many STILL think that IRaq had a role in 9/11?) Our academic elite commentators (Leveretts excepted) are just talking head, mostly pushing the agendas of their paymasters at their think-tanks (lobby groups.)

    So basically, what’s left of our system of Democracy that actually works? When push came to shove, all of the theories about how democracies function fell flat. Hate to say it but our democracy has shown itself to be a farce.

  7. Cyrus says:

    Fahad — the IRanians have already enriched to 20%, as verified by the IAEA. Iran tried to obtain its enrichment program in the “legalized way” in 1983, when the US pressured the IAEA to drop its technical assistance program to Iran. Iran’s actions are still quite legal.

  8. Alan says:

    Flynt & Hillary – sorry for the delay in replying to your question to me on the last post. I was indeed referring to Geoff Forden’s ACW piece which you use here (and referenced by Cyrus yesterday), so no harm done I suppose!

    That said, the sourcing of isotopes from abroad TODAY is a bit murky, as is the actual production at the TRR. This is a quote from Soltanieh on PressTV on Feb 23:

    “They were importing the radioisotopes when I was director of the center. There were many times when they did not send the radioisotopes to Iran on the right time. Many hospitals were waiting and we had difficult conditions. I am happy to say that we are producing radioisotopes for our people for the last 10 years or so and we are not importing any more.”

    This conflicts with the ACW report, but I don’t know whether Soltanieh would necessarily know whether ALL isotopes used were made in Iran or not. If we’re talking about a supply of $500,000 a year, it is peanuts, and could conceivably be organised through Iranian pharmaceutical distribution companies with hospital contracts sourcing from Europe.

    On whether the TRR is currently making isotopes, it appears that Iranian scientists have come up with and implemented new proprietary methods for producing isotopes over the years (I have seen references from 2003 and 2007). The latest appears to have been published this month in Nuclear Technology, entitled “Industrial-Scale Production of 99mTc Generators for Clinical Use Based on Zirconium Molybdate Gel”.

    This I think is the method referred to in various IAEA documents that refer to Iran wanting to start a NEW isotope production technique, and may have resulted in some confusion over whether or not Iran was currently making isotopes using other techniques, which they are, but won’t be able to beyond the end of 2010.

  9. Liz says:

    Fahd:

    The TRR instillation today is very different from what it was 40 years ago. It is much larger and highly developed. In addition, your claim that their “enriched LEU is contaminated” has not been stated in any of the IAEA reports.

  10. Jon Harrison says:

    This is quite interesting, but the technicalities are somewhat beyond me. Reading everybody’s stuff is helpful in getting up to speed.

  11. Dan Cooper says:

    Putin said the long-delayed Bushehr nuclear plant in Iran will start operating this summer. Vladimir Pavlov, chief of construction at the plant, said at a meeting with Putin that the launch was scheduled for July.

    Speaking to reporters after talks with Foreign Minister Sergei Lavrov, Clinton said the announcement would send the wrong message to Iran and that the world needed to know that Tehran was not trying to build nuclear weapons.

    Lavrov said Russian builders would start the long-delayed plant anyway and that further diplomacy on the issue was needed.

    In an interview to Rossiiskaya Gazeta published Thursday, Lavrov also remained aloof on ties with Washington. “I won’t say that [Russia and the United States] are enemies, but we’re not friends, either,” he told the state’s newspaper of record.

    http://www.themoscowtimes.com/news/article/clinton-putin-to-hold-first-meeting-friday/402120.html

  12. Fahad says:

    I do not think that they are able to enrich to 20% without destroying their centrifuges in Natanz. Their so far enriched LEU is contaminated. It’s a bluff, and everybody knows. The urgent need for isotopes on the other hand is real. That the TRR is more than 40 years old means that it is probably better shut down. The swap deal was attractive not only for the US and P5+1. Iran would have got its enrichment program legalized in a way. Western powers have now considerable leverage. It’s a chess match.

  13. Eric A. Brill says:

    Little did we know Flynt and Hillary’s next piece would be on the very topic we’ve been discussing. I am just moving this from the previous thread:

    Hass,

    “I think a better question to ask is why the US prevents the sale of the reactor rods for the TRR.”

    Few doubt that the US will try to delay sales as long as possible. But even the US must recognize it cannot block Iran forever from obtaining fuel for the TRR. At some point, after all, Iran would get to play its “800,000 suffering patients” ace-in-the-hole.

    So Iran needs only to ensure that it does not get compromised by the delay. I think the best way to accomplish that is to do exactly what it’s doing – enrich uranium to 20% and figure out how to make fuel plates – with just one added wrinkle: Offer to swap or sell its 20% uranium if and when Iran is actually permitted to buy fuel plates for the TRR (or to obtain them in some swap).

    That sweetener would provide Iran just the answer it needs to my tough question posed earlier (”Why are you making it when you can just buy it?”):

    “We’re making it because we haven’t actually been permitted to buy it yet, despite all the earnest assurances that we’ll be allowed to, and goodness knows we’ve tried. Let us know if and when that changes. We’ll have our checkbook ready, and we’ll also be happy to swap whatever 20% uranium we’ve got on hand when you call. In the meantime, we sure are learning a lot about how to refine uranium and make fuel plates!”