Sunday 27 April 2014

The new World Anti-Doping (WADA) Code 2015

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].


  1. Don't think rationalisation of substances tested for is the reality - intention is minimum menu of substances and add blood tests for growth hormone, HBOCs, insulin. Consultation currently ongoing. Reduction of screens could be costly for laboratories.. New Code also allows laboratories to analyse 'on suspicion'. Q - who is paying for this??

  2. I agree. Lots of potentially good ideas but how to pay to implement across the board? Rich sports (cycling, football, athletics) may be able to fund targeted testing on all their top athletes. But what about the poorer sports? Also there is no chance to test people before they become elite, especially in the developing world. So long term benefits following doping in children would be a problem to pick up. Nothing is a panacea, but that doesn't mean we shouldn't do something of course.