A special issue of the British Journal of Sports Medicine has just
been published on sports doping [1]
linked, in part, to the new WADA code coming out in 2015. Some articles are
freely available so can be read not just by those of us fortunate to have
university subscriptions to the journal (wouldn’t it have been nice if WADA had
funded all the articles to be open access so everyone could take a look at the
science and ethical discussions?).
I haven’t had time to read everything yet, but two papers caught my eye [2, 3]. The first is called “Time to change” and it is a
road map to guide the implementation of the World Anti-Doping Code 2015 [2]. This jibes with many
of the ideas presented in my book. For example anti-doping testing alone is
doomed to limited success without active government investigation, preferable
by police and the judiciary. Having different strategies for different sports,
and making this explicit, seems a genuinely new idea. Why test for anabolic
steroids and EPO in football (soccer) when the evidence is very limited that
these are being abused? Instead focus limited resources on areas where the
abuse is taking place. Of course one problem is that the report, quite rightly,
favours transparency. But if athletes know that a type of drug is less
likely to be tested, that might in itself encourage use of that drug to
increase (we know this happened when caffeine and pseuodoephedrine were removed
from the banned list). So WADA might be hitting a moving target.
One beneficial move is the idea that
samples should be stored for ten years. Previously lengthy storage was only
mandatory for Olympic Games samples. This allows for later checking of samples
as new analytical tests are developed. I think this is a genuine deterrent, as
athletes who cheat will always worry that they have left a “smoking gun” in a
laboratory somewhere.
Another interesting idea is the expansion
of the biological passport system. This is a little over hyped; it really only
works currently for limited aspects of blood doping. However, a paper in the
same issue by Yannis Pitsalidis is promising in this respect [3]. It shows that
gene expression is changed for up to four weeks following EPO administration. So-called
“omics” approaches might provide a genuinely new tool in the anti doping
armoury, especially if they could be expanded to other hormone drugs. A note of
caution is advised. It is unlikely that there will be a single passport profile
that will apply to whole classes of drugs. My gut feeling is that gene and
metabolite profiling will need to be separately validated for every drug or
drug sub class. This would be a very expensive process but it is necessary if a
passport anomaly alone were to be used to ban an athlete. However, a more
general profile could still be an invaluable tool to aid investigation and
target further testing.
These changes, whilst laudable on the
surface, need to be treated with some caution. The biggest barrier to fair
sport is the widespread inconsistencies in out-of-competition testing in
different countries. WADA is not a world policeman. It is only as good as the
local anti-doping agencies. Concerns about how effective the testing regimes
are in Kenya and Jamaica come to mind. It does not matter how sophisticated
your testing regime if no one is tested [the Jamaican anti doping
agency conducted only one out-of-competition test in the six months leading up
to the 2012 Olympic Games in London].
