Evidence-based advocacy: the public roles of health care professionals

To the Editor: In his exploration of the health advocacy potential of modern clinicians, Gruen1 observes that the public first needs to be convinced that “the profession has its own house in order”. Unfortunately, one room in that house accommodates one of the serious health threats identified by the author: terrorism. Currently, over 95% of the world’s radiopharmaceuticals are generated from highly enriched (bomb-grade) uranium (HEU), an unnecessary nuclear weapons proliferation hazard.2 Prompt conversion of the global medical isotope supply chain to low enriched uranium (LEU, containing less than 20% uranium 235, so not viable for weapons production) is technically feasible.3 Clinicians are thus uniquely placed to advocate conversion to the use of LEU, while pressuring their imaging and isotope providers to end reliance on HEU, thereby blocking one of the most vulnerable pathways to producing a “terrorist bomb”.