August 14, 2017
C. Norman Coleman, Silvia Formenti, Miles A. Pomper
This article originally appeared in World Politics Review on August 11, 2017.
A recent report in The Washington Post that the self-proclaimed Islamic State almost stumbled upon radioactive material in Mosul—in the form of cobalt-60, a substance used in radiation therapy—raises a profound dilemma about cancer treatment in developing countries and the risk of terrorists obtaining a key ingredient for making “dirty bombs.”
Cobalt-60 radiation machines are one of the many tools doctors have used in the treatment of cancer for the past 50 years. In North America, nearly all of these units have been replaced with more advanced technology called linear accelerators, which do not contain radioactive material and provide medically superior treatment. In developing countries, the cobalt-60 radiation machines remain prevalent. They are cost-effective and appealing in states with limited or intermittent electricity supplies and other physical infrastructure as well as a shortage of medical and technical expertise.
Iraq still has two cobalt-60 machines, according to the International Atomic Energy Agency, having already transitioned to linear accelerators for its 10 other treatment machines. But as Mosul made clear, using even one or two of these radiation machines comes with security risks. If the wrong people, such as members of the Islamic State or another terrorist group, got hold of cobalt-60, they could potentially create a dirty bomb or a radiation exposure device. With more than 70 percent of all cancer deaths now occurring in developing countries, the problem of balancing cancer treatment with security risks will only get worse.
The surest way to prevent terrorists from acquiring these materials, while not limiting people’s access to necessary cancer treatment, is to phase out cobalt-60 radiation machines and replace them with linear accelerators. The U.S. National Nuclear Security Administration, which is in charge of efforts to secure potentially dangerous radioactive material, has been supporting this approach for several years. To do so, developing countries need better technology and treatment environments, not only to support this transition away from cobalt-60 machines but to improve cancer treatment overall.
