Critical Medical Radioisotopes: Shortage and Supply Initiatives
Why in News?
In August 2025, the Government of India acknowledged in Parliament that the country faces a 10–15% shortfall in the supply of critical medical radioisotopes used for cancer diagnosis and treatment, including Iodine-131 (I-131), Molybdenum-99 (Mo-99) and Fluorine-18 (F-18). The shortage has led to disrupted diagnostics and delayed treatments, especially in smaller cities.
What are Critical Medical Radioisotopes?
Medical radioisotopes are unstable atoms that emit radiation and are used in nuclear medicine for:
In August 2025, the Government of India acknowledged in Parliament that the country faces a 10–15% shortfall in the supply of critical medical radioisotopes used for cancer diagnosis and treatment, including Iodine-131 (I-131), Molybdenum-99 (Mo-99) and Fluorine-18 (F-18). The shortage has led to disrupted diagnostics and delayed treatments, especially in smaller cities.
What are Critical Medical Radioisotopes?
Medical radioisotopes are unstable atoms that emit radiation and are used in nuclear medicine for:
- Diagnostic imaging (e.g., PET, SPECT scans)
- Targeted cancer therapy (radioligand therapy, brachytherapy)
- Treatment of thyroid disorders, bone metastases and other conditions.
Key isotopes include:
- Technetium-99m (Tc-99m) – derived from Mo-99; the most widely used isotope for diagnostic imaging.
- Iodine-131 (I-131) – used for thyroid cancer and hyperthyroidism.
- Lutetium-177 (Lu-177) – used in targeted therapy for neuroendocrine tumours and prostate cancer.
- Fluorine-18 (F-18) – used in PET scans for oncology, cardiology and neurology.
- Actinium-225 (Ac-225) and Radium-226 (Ra-226) – emerging isotopes for targeted alpha therapy in advanced cancers.
India’s Production and Demand Status
According to parliamentary replies:
According to parliamentary replies:
- Lutetium-177 (Lu-177):
- Domestic production: 1,000–1,200 Curie.
- The Board of Radiation and Isotope Technology (BRIT) meets about 85–90% of national demand; a 10–15% gap remains.
- Iodine-131 (I-131):
- Domestic production: 1,000–1,200 Curie.
- Still insufficient to meet total national demand.
- Molybdenum-99 (Mo-99):
- Domestic production does not fully meet demand; India relies partly on imports.
- Fluorine-18 (F-18):
- Production: 300–400 Curie, mainly at cyclotron facilities (e.g., Mumbai Cyclotron).
- Supply is localised and not sufficient for nationwide needs.
Causes of Shortage
- Global supply disruptions:
- Shutdowns or outages of major research reactors (e.g., in Canada, the Netherlands) that produce Mo-99 have historically triggered global shortages.
- Aging infrastructure:
- Many global producers rely on aging research reactors and legacy processing facilities.
- Rising demand:
- Rapid expansion of nuclear medicine, PET-CT centres and radioligand therapies has increased demand faster than supply capacity.
- Logistical constraints:
- Radioisotopes have short half-lives; transport delays and limited regional production centres affect availability, especially in smaller cities.
Recent Indian Initiatives
- The government has indicated plans to expand domestic production of isotopes like Mo-99 and Lu-177 through:
- Upgradation of existing facilities (e.g., CIRUS, Dhruva reactors; cyclotrons).
- Strengthening BRIT and Radiopharmaceuticals Programme under the Department of Atomic Energy (DAE).
- Emphasis on self-reliance in critical isotopes to reduce import dependence.
Significance
- Health impact: Shortages directly affect cancer staging, treatment planning and timely therapy, potentially worsening outcomes.
- Strategic importance: Reliable domestic production of critical isotopes is vital for health security and reducing dependence on geopolitically sensitive supply chains.
- Scientific and industrial growth: Expansion of isotope production supports growth in nuclear medicine, radiopharmaceuticals and biotechnology.
- Equity: Ensuring availability beyond metro cities is crucial for equitable access to advanced diagnostics and therapy.
