Australia's nuclear medicine agency chartered flights to deliver children's cancer treatment

Australia’s nuclear medicine agency has spent more than $350,000 on chartered flights to deliver critical medicines to diagnose and treat children’s cancer, as the Covid-19 pandemic exposes worrying gaps in health supply chains.

As it prepares to give evidence to a parliamentary inquiry on Tuesday, the Australian Nuclear Science and Technology Organisation has revealed how widespread flight cancellations temporarily put at risk the supplies of certain nuclear medicines.

Ansto disclosed the charter flight costs in response to questions from Guardian Australia, saying that it was “focused on doing everything we can to continue the supply of life-saving nuclear medicine for Australians around the country”.

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It said it had also needed to deliver medicines to Brisbane by truck since April, with this road freight costing $4,000 per week, split between Ansto and its customers.

Australia lost the capacity to make the radioactive isotope iodine-123 - used in the diagnosis and treatment of cancer in the nerve cells of children – just over a decade ago with the closure of the National Medical Cyclotron in Camperdown, NSW.

But according to Ansto, iodine-123 is needed in clinical settings by about a dozen patients around Australia at any one time – most of them children with neuroblastoma. This means Australia now relies on imports from Japan.

But with a half-life of just over 13 hours – meaning the levels of radioactivity halve every 13 hours – this isotope needs to be distributed to Australian hospitals and health centres very quickly. It expires within 33 hours of being manufactured in Japan.

“The challenge with transporting nuclear medicine is the products have a short half-life,” Ian Martin, the general manager of Ansto Health, told Guardian Australia.

“We need to get the isotopes from point A to point B before they decay too much to be effective, a complex task when B is in another hemisphere.”

In response to questions, Ansto said the chartered flights included one from Japan to Sydney, followed immediately by flights from Sydney to Brisbane, Adelaide, Perth and Melbourne – illustrating the rush to get the isotope to where it was needed.

Given that Covid-19 is causing ongoing disruptions to normal supply chains, Ansto said it was continuing to work with clinicians to refine delivery logistics and ensure nuclear medicine reached Australian patients in need.

Martin thanked those who had helped Ansto deal with these “difficult circumstances”, including the airlines Qantas, Virgin and ANA.

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His comments expanded on a submission to a parliamentary committee, in which Ansto said the international and domestic charter flights were needed to “ensure that this essential product reaches patients, at not insignificant expense”.

The submission also noted that the case “highlights the potential for disruption to the import of nuclear medicines caused by pandemics”.

Despite the difficulties with iodine-123, Ansto said it produced a number of other important nuclear medicines in Australia. These include molybdenum-99 (Mo-99) which is used to make a radioisotope commonly used for the diagnosis of conditions such as cancer, heart disease and neurological disorders.

The submission said the completion of the Ansto Nuclear Medicine Facility in 2019 meant that the organisation was able to meet domestic demand in Australia while also supplying up to 25% of the Mo-99 required globally.

It is pursuing contracts in existing markets, such as North America and Europe, and predicts an increase in use in growing markets especially in Asia. Ansto said the pandemic had “underscored the importance of Australia having a domestic Mo-99 production capability”.

“The reduction in flights as a result of Covid-19 has meant that access to overseas supplies of this important isotope has become more difficult and more unreliable,” it said.

“If Australia did not have such a capability, there could have easily been major shortages in supply of this lifesaving product during the height of the pandemic, especially given our remoteness from the main producers in Europe.”

Witnesses from Ansto are expected to expand on these issues when they appear before the joint standing committee on foreign affairs, defence and trade on Tuesday afternoon.

The committee is looking at supply chains as part of its inquiry into the effect of Covid-19 on Australia’s defence, trade and international relations.

The inquiry chair, Liberal senator David Fawcett, said the committee wanted to hear from Ansto because it was a leading producer and exporter of some of the most important nuclear medicines used in diagnosing and treating cancers, heart disease and neurological disorders.

“Ansto has worked hard to ensure Australians have ongoing access to vital nuclear medicines during the Covid-19 pandemic, but it is also doing important work in the processing of rare earth metals, an area that has great potential to enhance Australia’s sovereign capabilities,” Fawcett said.

In earlier hearings, the committee was told that Australian companies had experienced “shocking” price gouging and had trouble accessing critical supplies to make medicines and personal protective equipment at the height of the pandemic.