Centres of excellence

I was at an international conference in Madrid, Spain in the summer of 2004 when I was accosted by a member of the delegation from the Philippines. She told me of a Filipino physician who had set up a cancer therapy clinic and who obtained a used radiation therapy source from a hospital in the US. The source was similar in activity to the one that caused four deaths and a huge amount of contamination in Goiania, Brazil in 1987, and it had apparently been shipped without first informing the government of the Philippines.

“How can your government allow this?” she demanded. “How can you just let a hospital ship a high-activity radioactive source to another nation without first checking to see if the clinic is even real, or is even allowed to have radioactivity?”

My reply was that (at that time) any licensee could legally ship radioactive materials to any other licensee as long as the receiving licensee provided a copy of their radioactive materials license to the shipper, showing that the receiving licensee was authorized to possess that amount of radioactive materials. In other words – at that time – I could ship a dangerously radioactive source to anyone in the world based only on their faxing me a copy of their license, with no requirement to ask for verification of authenticity from the regulators. The potential for abuse should be obvious, and luckily our regulators have put much stricter controls in place in recent years. At the time, however, all I could tell my Filipino colleague was that the American hospital had acted legally, if not entirely intelligently.

The reason for mentioning this is that the United Nations issued a press release recently noting that the international body is creating eight “Centres of Excellence” around the world to “help countries mitigate the risks related to chemical, biological, radiological and nuclear (CBRN) material, notably by promoting coherent national and regional policies that allowed them to better share information and best practices.”

This is a great idea – developing internationally recognized “best practices” and encouraging their adoption by as many nations as possible is a great way to reduce the risk that a terrorist group might take advantage of mismatched regulations to assemble the materials they might need to launch a devastating chemical, biological, radiological, or nuclear attack. Yet at the same time, I find myself hoping that these centers will go beyond the scope that is currently envisioned and that they can live up to their potential for doing good.

Let’s take one example – from the field I know best. There are currently internationally accepted standards for radiation safety that have been implemented world-wide – the International Atomic Energy Agency’s Basic Safety Standards (BSS) for radiation. I think it’s safe to assume that virtually every nation on Earth either uses these as the basis for their radiation regulations or is at least aware of them – this series of documents (there are more than the one linked to above, but that one is the most fundamental) covers much of what is considered to be “best practices” for the safe use of radiation and radioactivity. In the case of radiation safety, and trying to avoid a radiological attack, there may be little or no need to make others aware of these standards, but there is a great need to help many nations understand their importance and how to comply with them. In fact, you can make a very convincing case that the written regulations are only the first step in having a good radiation safety program, and trying to get everyone in the world to accept the IAEA standards is only a good first step. But the crux of the matter is in how to apply the standards – whether they are going to be useful or if they turn out to be just another set of documents and rules on the shelf.

Take ALARA for example. ALARA is the fundamental philosophy of radiation safety around the world – to keep radiation exposure to anyone As Low As Reasonably Achievable. This is a great goal, but what does it mean? More importantly, how do I know what I should consider to be “reasonable?” Does it make sense to have everyone wear latex gloves when working with radionuclides? Probably (except for those with latex allergies), because latex gloves – in much of the world – are plentiful and cheap. But what about those nations where gloves are hard to find – is it better to work barehanded (risking skin contamination) or to re-use gloves (risking the accumulation of radioactivity and the spread of contamination around a lab)? And in wealthy nations does ALARA mean wearing a whole-body “moon suit” with forced air? What I’m getting at is that teaching the rules is easy – helping people to understand how to interpret and to use the rules is more difficult and I sincerely hope that the Centres of Excellence will be sending people to spend time on the ground helping their colleagues to learn not only the accepted standards are, but how to use them thoughtfully, skillfully, and sensibly.

I hope, too, that these centers will be a place where information can be shared between participating nations and agencies – where participants can share their problems and the solutions they devised, where they can share procedure and policy manuals, where they can post checklists and flowcharts; in short, where participants can share with each other all of the minutiae that goes into building and sustaining a high-quality program in whatever field they are working in. This sort of “nuts and bolts” stuff might not be very exciting, but it is the practical heart of any good on-the-ground program. Telling a person to conduct, say, radioactive materials security inspections quarterly is a good start – sharing your inspection checklist with him and including pointers on common problems (hopefully during an in-person training visit!) helps to turn that printed requirement into an inspection that actually adds materially to radioactive source security.

Finally, I would add that this sort of work – the international sharing of this level of information – cannot help but to make all of the participating nations safer on a daily basis. Helping to better secure radioactive sources, for example, could have saved at least one life in India in 2010 and would have eliminated the whole radioactive tissue box fiasco earlier this year. The intent of these centers is to help reduce the massive impact of an attack using WMD and that is a laudable goal – but the “collateral benefit” from these centers is potentially substantial enough to justify their existence even in the absence of anything else.

I am encouraged by the United Nations’ decision to stand up these centers – if their charter is sufficiently broad I think that they can do a world of good in helping to prevent needless risk on a daily basis as well as by helping to prevent a terrible attack. I sincerely hope that they will be able to live up to their potential by becoming not just centers from which to promulgate regulations and rules, but that they will also become clearinghouses of practical information, personal mentoring, and hands-on training.

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