OTTAWA — The repercussions of the war in the Middle East have led to reductions in helium supplies for healthcare services in at least one province. Experts warn that Canada has not done enough to ensure its sovereignty over essential medical supply chains.
The health authority of Saskatchewan says it was warned by its supplier that its allocations of liquid helium, used in MRI machines, “will be temporarily reduced by 50%.”
A spokesperson stated that there is currently no impact on patient care. However, researchers who rely on helium have been raising concerns about supply issues for years.
“We need to establish a sustainable, stable helium supply in Canada,” assured Geneviève Seabrook, director of the nuclear magnetic resonance research center at the Princess Margaret Cancer Center in Toronto.
Iranian strikes against Gulf countries in early March forced the national petroleum company, QatarEnergy, to close a major liquefied natural gas terminal, citing force majeure. This means they are unable to supply customers due to circumstances beyond their control.
Helium is a byproduct of natural gas processing, and Qatar is one of the world’s largest suppliers of liquid helium.
Liquid helium is used as a refrigerant in MRI machines and nuclear magnetic resonance spectrometers used for scientific research.
Air Liquide, the self-proclaimed largest distributor of liquid helium in Canada, has also declared force majeure and warned some clients that their supplies were being cut in half and prices would increase.
HealthPRO Canada, a non-profit organization that assists about 2,100 medical facilities in Canada with procurement, serves approximately 80% of the country’s hospitals and health authorities.
The president and CEO of HealthPRO, Christine Donaldson, stated that the organization is challenging price hike notices. “We have not accepted this price increase. In fact, we are reviewing each contract individually and collaborating with our suppliers to ensure they fulfill their commitments,” she explained.
As of now, no patients have been affected, according to Donaldson. The organization is currently assessing its clients’ needs in case the shortage persists.
“Our assessment focuses on the age of certain MRI machines, and we are working with one of our partners to determine if it is possible to target those at higher risk,” she specified.
Installing new MRI machines requires thousands of liters of liquid helium. Once filled, these machines only need to be topped up once or twice a year, although older machines consume helium more quickly.
Seabrook helped found the Canadian Helium Users Group (CHUG), which advocates for Canadian investment in helium purification and liquefaction at a national level.
Most of the helium extracted during LNG production in Canada is shipped to the United States for liquefaction. Spectrometers like the one used by Seabrook in her research consume much more helium than MRI machines: her two instruments require about 500 liters every five weeks.
If helium were to run out, she explains, the magnets could “quench” – rapidly lose their superconductivity – damaging the machines irreparably and delaying research by several years.
“This would be a disaster,” Seabrook asserts.
A Long-Standing Issue
Helium shortages were already observed during the COVID-19 pandemic and at the beginning of the war in Ukraine. Russia is also a major helium supplier.
Anne Snowdon is the scientific director and CEO of the Supply Chain Advancement Network in Health. Her research focuses on issues relating to Canada’s medical supply chains.
According to Snowdon, the country’s 13 healthcare systems are unable to anticipate global supply shortages.
“One reason is that no one is accountable for this problem. There is no organization in the country that is, by definition, responsible for managing and preparing for product shortages,” she points out.
On average, Snowdon says 3,000 distinct shortages occur annually in Canada’s healthcare system, affecting products ranging from IV tubing and needles to medical imaging contrast agents and medications.
The closure of the Strait of Hormuz due to the war delayed deliveries of active pharmaceutical ingredients, particularly from India, one of the largest global suppliers. These raw materials are shipped to countries like Canada to be turned into medications.
A 2022 study for the Canadian Generic Pharmaceutical Association revealed that over 90% of active pharmaceutical ingredients used in Canada are imported.
Although no medication shortages have been observed among its members so far, the Canadian Generic Pharmaceutical Association stated in a release that rising costs in the supply chain are a cause for concern.
In 2023, the federal government invested $80.5 million in the Canadian Essential Medicines Initiative to address medication shortages during the COVID-19 pandemic.
This funding was awarded to Applied Pharmaceutical Innovation, a nonprofit Alberta-based company, which claims it will be able to produce active pharmaceutical ingredients in Canada in the near future.
CEO Andrew MacIsaac announced that the low profit margins in the generic pharmaceutical sector mean his plant will not be able to replace imported ingredients, although it could act as a short-term supplier if needed.
“Imagine if an East Canadian drug manufacturer suddenly ran out of supply from a Chinese supplier. We can step in and become their secondary site, capable of providing the necessary capacity,” he explained.
Donaldson stated that, for now, HealthPRO Canada suppliers are required to maintain a stock of three to six months of these active ingredients to address any shortages.
“We have greater leeway, allowing us to continue our operations if we see signs of supply issues abroad,” she stated.
Snowdon suggested that officials from all provinces should take advantage of this time to begin genuine collaboration.
“If you collaborate, you will stop competing against each other. We are too small to afford competing against ourselves and the rest of the world,” she said.
