When cargo delays become missed treatments

The IAEA is calling for radiopharmaceuticals to be treated as priority medical cargo, highlighting that transport delays can directly affect patient treatment. While international safety regulations for radioactive materials are already established, the agency argues that inconsistent implementation across the transport chain remains the main challenge. Operational barriers, rather than regulatory gaps, are limiting reliable radiopharmaceutical transport. Differences in national requirements, limited awareness, airline and airport acceptance issues, and risk perception are contributing to shipment delays and denials despite growing demand for time-critical medical materials. The IAEA is advocating greater coordination across governments, aviation stakeholders and industry to improve transport reliability. Recommended measures include stronger awareness, maintaining airport handling capabilities, improving regulatory alignment and recognising radiopharmaceutical shipments as essential healthcare cargo. The International Atomic Energy Agency (IAEA) is calling for radiopharmaceuticals to be recognised as priority medical cargo after warning that delays in transporting radioactive medical materials can directly affect patient treatment. Speaking during the joint IATA-UPU-ICAO Air Mail Safety webinar, the agency presented findings from its work on the safe and secure transport of radioactive material, arguing that the challenge is no longer the absence of international regulations but inconsistent implementation across the transport chain. At the centre of the presentation was a clear message: radiopharmaceuticals are both time-critical and life-saving, meaning transport reliability has become an essential part of healthcare delivery rather than simply a logistics issue. The presentation states: “Radiopharmaceutical Delay (= Denial = Missed treatment).” According to the IAEA, the international regulatory framework governing the transport of radioactive material is already well established. The agency highlighted that its SSR-6 regulations provide the basis for Class 7 dangerous goods requirements across all transport modes, with aviation requirements incorporated through ICAO’s dangerous goods framework and national regulations. However, the presentation argues that regulatory compliance alone has not eliminated operational barriers. One slide identifies a “system gap”, stating that compliance exists, but implementation fails, resulting in operational inefficiencies and inconsistent interpretation while demand for radiopharmaceutical transport continues to increase. Rather than focusing on changing regulations, the IAEA’s work concentrates on improving how existing rules are applied throughout the supply chain. The agency identifies air transport disruptions and limited acceptance by airlines and airports as among the principal barriers affecting the movement of radiopharmaceuticals. Other challenges include differing national regulations, lack of harmonisation and limited awareness, which the presentation suggests can lead risk perception to outweigh patient benefit. The presentation stresses that reliable transport is fundamental because radiopharmaceuticals often have strict time constraints. Its conclusion is direct: “Reliable transport = patient care,” warning that without action, denial or delay of shipments risks becoming “a healthcare crisis.” The findings are supported by work carried out by the IAEA’s Denial of Shipment Working Group, established for the 2023-2026 period with participation from 75 representatives across 30 Member States, three international organisations and five non-governmental organisations. The group approved its White Paper on transport facilitation in April 2026. According to the White Paper summary presented during the webinar, the principal causes behind shipment denial or delay include: • perception and cultural factors; • awareness gaps; • regulatory complexity and lack of harmonisation; • insurance and economic barriers; and • carrier and logistics issues. The presentation links these issues to wider consequences, including negative impacts on patient healthcare, increased costs, operational delays that may introduce safety or security risks, and regulatory non-compliance risks. Rather than proposing new dangerous goods regulations, the IAEA recommends stronger coordination between governments, aviation stakeholders and industry. Among the measures outlined are treating radiopharmaceuticals as priority medical cargo, strengthening cooperation between states, aviation authorities and industry, improving awareness through simple communication, maintaining airport and port capability for radioactive shipments, and expanding international cooperation on transport facilitation. The agency also recommends that operators submit proposals to IATA where changes to Special Handling Codes could improve the facilitation of medical radioactive material, while Member States are encouraged