Challenges in radiopharmaceutical importation across six Southern African Development Community countries: an exploratory study

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Introduction: Radiopharmaceuticals are the backbone of nuclear medicine, essential for accurate diagnosis and effective treatment of various diseases, particularly cancer. Yet across the African region, patients still face delays in nuclear medicine services because radiopharmaceuticals are not available when needed. Due to radionuclide short half-lives, supply delays compromise their effectiveness because of rapid radioactive decay. Aim: This study aimed to investigate, in six English-speaking South African Development Community (SADC) countries, factors that affect radiopharmaceutical importation, identify similarities and differences in their importation processes, determine the customs handling procedure, and identify areas for potential improvement in their importation. Method: The study was an exploratory pilot study. An online questionnaire SurveyMonkey® was distributed to healthcare professionals and distributors with experience in radiopharmaceutical importation in the six target countries via email. Results: Based on 10 completed and two partially completed surveys. The preliminary results suggest that importation costs, frequent logistical delays due to limited transport options, inconsistent customs clearance procedures, and a limited number of suppliers negatively affect access to radiopharmaceuticals in the region. These factors collectively disrupt timely delivery and compromise the availability of nuclear medicine services. Discussion: The importation of radiopharmaceuticals between individual SADC member states is hindered by high import costs, unharmonized customs regulations, limited production capacity, and inefficient transport systems. South Africa remains the main regional supplier, yet its market dominance and high costs restrict access for neighboring countries. Strengthening regional collaboration, harmonizing customs procedures, and expanding local production capacity are essential to improve the accessibility and sustainability of radiopharmaceuticals in the region.

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