Global Issues of Radiopharmaceutical Access and Availability: A Nuclear Medicine Global Initiative Project

Abstract

The Nuclear Medicine Global Initiative (NMGI) was formed in 2012 by 13 international organizations to promote human health by advancing the field of nuclear medicine and molecular imaging by supporting the practice and application of nuclear medicine. The first project focused on standardization of administered activities in pediatric nuclear medicine and resulted in two manuscripts. For its second project the NMGI chose to explore issues impacting on access and availability of radiopharmaceuticals around the world. Methods. Information was obtained by survey responses from 35 countries on available radioisotopes, radiopharmaceuticals and kits for diagnostic and therapeutic use.Issues impacting on access and availability of radiopharmaceuticals in individual countries were also identified. Results. Detailed information on radiopharmaceuticals utilized in each country, and sources of supply, was evaluated. Responses highlighted problems in access particularly due to the reliance on a sole provider, regulatory issues and reimbursement, as well as issues of facilities and workforce particularly in low-and middle-income countries. Conclusions. Strategies to address access and availability of radiopharmaceuticals are outlined, to enable timely and equitable patient access to nuclear medicine procedures worldwide. In the face of disruptions to global supply chains by the COVID-19 outbreak, renewed focus on ensuring reliable supply of radiopharmaceuticals is a major priority for nuclear medicine practice globally.

Maximal covering location problem for nuclear medicine clinics allocation in Nigeria

“…Recent advances in imaging technology and radiopharmaceutical development point to a boom in nuclear medicine applications for diagnosis and treatment globally [23,24]. NM is vital to the detection and treatment of cancers, yet most sub-Saharan African countries face challenges with the provision of NM services [25].…”

“…As part of health strategic plans, most developed countries determine their nuclear medicine-specific targets following a needs assessment. Developing countries on the other hand often require financial and technical assistance to establish NM facilities and sustain their operations [24,25,29]. While AKTH and JUTH are federally funded hospitals, it is likely that their proximity to Abuja and the need for geopolitical balance may have discouraged their inclusion in the Fig.…”

Underutilisation of nuclear medicine scans at a regional hospital in Nigeria: need for implementation research

“…NM diagnostic and treatment procedures are among the most powerful analytic tools for decision-making in the management of cancer, cardiovascular and neurological diseases. Appropriate utilisation of NM tools has led to fewer patients undergoing invasive and costly tests and sometimes unnecessary treatments including invasive surgeries [ 3 ]. The impact of NM on the management of cancer led to the strengthening of NM capacity by the International Atomic Energy Agency (IAEA) among member states in Africa, as a part of international cancer control efforts [ 1 – 5 ].…”

“…However, the growth of NM in Sub-Saharan Africa continues to face many challenges. The known barriers include ageing equipment [ 4 ], culturally embedded dread of radiation [ 6 ], logistic challenges with radionuclide delivery [ 3 , 7 , 8 ], lack of health insurance [ 9 ], as well as other systemic barriers that limit health systems in developing countries [ 2 , 10 ].…”

Global Advancement of Nuclear Medicine: KSNM 60 Years of Achievements

“…We must also work towards ensuring that the opportunities for new diagnostic and therapeutic approaches for nuclear medicine are shared among all countries and allow access to patients despite differences in the economic status of that country. Two recent global reviews of equipment and workforce [7], and access to radiopharmaceuticals [8], have clearly shown the challenges faced in low and middle income countries to providing nuclear medicine services to their populations. With this information we have the opportunity to advocate for improved infrastructure and enhanced workforce and training, in our region and globally.…”