Sustainability Challenges: Anti-Doping

Ever since the earliest Olympic Games doping tests were conducted in 1968, the challenge to keep sport clean has evolved against a backdrop of new substances and methods designed to boost athletic performance whilst violating the rules and spirit of the competition.

However, as Michele Verroken, Anti-Doping Adviser and Director, Sporting Integrity, observes: “Anti-doping in sport has evolved significantly over the past 60 years in many ways; in other ways it has hardly progressed at all!”

For decades, there has been an evolution in the types of substances and methods that are used by those who deliberately flout the rules, presenting a perennial challenge to the rest who are trying to keep sport clean.

“As there has been since the beginning of ‘anti-doping’, there is an arms race between sophisticated dopers and anti-doping authorities,” says David Howman, the former World Anti-Doping Agency (WADA) Director General who now works with multiple sports organisations and international federations.

For example, in recent years “micro-dosing”, which allows some compounds like testosterone to clear the body more quickly if they are taken frequently and in small doses, has anecdotally become more common, according to The Guardian. Furthermore, sophisticated cheats have shifted to plant-based testosterone that bypasses the liver – which can leave a doping footprint – by using patches and gels.

When less familiar performance-enhancing drugs (PEDs), as well as steroids and erythropoietin (EPO) are also taken into account, the complexity of the core challenge becomes apparent.

Losing the battle?

Indeed, doping cheats currently appear to have the upper hand versus those who are trying to catch them.

According to WADA, the percentage of ‘Adverse Analytical Findings’ declined for six consecutive years to just 0.65% of samples analysed in 2021. Even the most optimistic observers would acknowledge that, considering the depth of research and anecdotal evidence available, such a percentage is unrealistically low. For example, according to The Economist, most experts in the field estimate that anything from one to four in every 10 athletes at the delayed Tokyo 2020 Olympic Games were doping.

This fall in the number of ‘positive’ results has occurred when simultaneously – with the exception of a pandemic-disrupted 2020 – testing has increased steadily year-on-year across all organisations, including World Anti-Doping Code signatories and non-signatories.

“Doping has become an art with multiple experts advising Athletes how to beat the system,” says Howman, who explains that “it is easy to use anti-doping testing as a fig leaf – to play the numbers game and do many tests for few results”.

He adds: “Quantity in testing seems to appease many and suggest there is no doping going on in a sport or a country. The aim or challenge for all those responsible for running anti-doping programmes must be to adopt a quality approach to the programme, and accordingly run intelligence-based testing that will detect sophisticated doping and thereby ‘catch the cheats’.”

Verroken adds that although the World Anti-Doping Code has established several necessary minimum standards that have improved operating processes and responsibilities, there is a need for others in the sector to build on those and adapt to the unique and specific elements of different sports.

On this point, Verroken says: “One size does not fit all, if we are to be relevant to athletes and impact on the values they hold about their sport.”

Athlete-first approach

A common consensus amongst experts in the field is that athletes, despite being one of the key stakeholders in the anti-doping process, are often an afterthought.

This disgruntlement goes to the heart of the biggest future challenge facing anti-doping: overhauling what many believe is an outdated testing system that is expensive, unnecessarily intrusive and not conducive to building a positive relationship with the athletes.

Under the established approach, Doping Control Officers (DCO) must be physically present when an athlete carries out a test, whether that is in or out of competition, with the athlete having to notify the authorities of their whereabouts in advance on given days. Out-of-competition tests usually last for at least an hour and typically take place at the athlete’s training base or their home.

Many athletes fail to update their whereabouts information online with religious accuracy, and even if they miss a test due to a genuine, unexpected urgent personal issue, it is rarely seen by the authorities as an adequate excuse.

“Athletes are very anxious as they know that one mini wrong move and they could be banned,” says Ali Jawad, a British Paralympic powerlifter and a member of the UK Anti-Doping (UKAD) Athlete Commission, who adds that “anti-doping testing is more stressful than competing.”

However, putting sportspeople at the heart of anti-doping strategies and procedures can ultimately boost compliance – ensuring tests run as smoothly as possible – as well as building trust between the athletes and authorities, potentially leading to an improved flow of anti-doping intelligence.

Speaking on an International Testing Agency (ITA) webinar, François Marclay, Intelligence & Investigations Manager at the ITA’s Cycling Unit, said: “Human intelligence is playing an indispensable role within the ITA I&I space. It is widely recognised as one of if not the most valuable source of anti-doping intelligence. It is therefore vital that Athletes (…) feel confident in reporting potential breaches, that they trust the organisation to whom they are reporting, and that they are provided with the opportunity to report these issues.”

Investigations by Sports Organisations and International Federations, WADA, National Anti-Doping Organisations (NADOs), law enforcement agencies and investigative journalists are increasingly the source of vital anti-doping intelligence.

Howman explains: “Not only must we all improve anti-doping science, but we must also continue to improve our approach to gathering, analysing and using intelligence to improve anti-doping programmes and thereby enhancing the arms race more in favour of the authorities.”

Resources

Anti-doping intelligence, investigations, research and education all require resources – and those are mostly gobbled up by testing – and specifically, sample collection.

The Institute of National Anti-Doping Organisations estimates that expenditure on testing for National and Regional Anti-Doping Organisations accounts for an average of 60% of each organisation’s budget.

As sports organisations and their partners increasingly adopt environmentally friendly strategies to reduce their carbon footprints, efforts to reduce unnecessary travel across all operations – including anti-doping – are likely to come under more scrutiny.

With this in mind, an increasingly digital landscape should provide optimism.

Although anti-doping procedures were disrupted by COVID-19 in 2020, the pandemic also gave proactive Authorities, such as the National Anti Doping Agency of Germany (NADA Germany) and USADA, the opportunity to explore new technologies and more athlete-friendly sample-collection processes, such as remote dried blood spot (DBS) tests via a video call, rather than in person.

When DCO travel costs – as well as potential accommodation and sustenance costs – are eliminated, tangible bottom-line savings are guaranteed, and more tests per day are possible.

Aside from the cost benefits, remote testing appears to have the backing of the Athletes. Following the USADA pilot, 86% of the athletes agreed or strongly agreed that “after the COVID-19 pandemic is over, I would like to see virtual collections continue to complement existing out-of-competition sample collection processes”.

Furthermore, shipping costs for DBS tests are typically lower than for heavier urine samples, and whilst energy costs in relation to refrigerating the latter are unavoidable, they are not required for the former.

Refining the process

Advances in science have already helped to refine the testing process. For example, sample-testing technology, for instance, has improved considerably over the years, with sensitivity having improved 1,000-fold over the past two decades to enable substances to be detected at parts per trillion, according to The Washington Post.

However, more broadly, there is plenty more to do in terms of data, technology and education.

Howman says that significant volumes of data collected in anti-doping processes are “not exploited efficiently in most programmes”. He adds: “There is a huge amount of untapped potential in the use of technology and data in anti-doping (…) Together with effective use of performance data and general intelligence, different data sources can and should be combined to create the best intelligence for anti-doping programmes.”

All governing bodies and anti-doping authorities – whether they are Code signatories or not – have a vested interest in ensuring their educational offerings are as effective as possible. Academic research has shown that carefully designed anti-doping education programmes have a significant impact on knowledge of the topic amongst athletes.

However, Ali Jawad warns that “the international standard of [anti-doping] education is at a low level”.

Verroken adds: “There are numerous ways we could and should be using technology to support education. However, it is still important to ensure relevance. So, one-size-fits-all remains a critical barrier to good quality education.

“As anti-doping systems have become more complex, understanding the anti-doping rules must have direct application to an athlete’s world. If we looked into every anti-doping rule violation as a failure of education, then perhaps we might understand better where we could do better.”

Future efficiencies

The long-term, top-line challenge is therefore to identify efficiencies with out-of-competition testing that will allow more financial and human resources to be ploughed into investigations and intelligence, and making education more accessible and impactful.

As a starting point, remote testing would appear to present a significant opportunity to save money and build trust with athletes.

The resulting savings can not only be used to support investigations and intelligence, as well as education, but can also be committed to research – another pillar of anti-doping that is squeezed by the reliance on expensive in-person testing.

As highlighted by prominent figures in anti-doping, such as USADA Chief Executive Travis Tygart, there is no suggestion that the “gold standard” of in-person testing should or will be eliminated. However, the clear possibilities presented by remote testing are impossible to ignore.

Indeed, the opportunity to explore any innovation that offers the potential to enhance sustainability, efficiency and trust in the context of the anti-doping conundrum should be seized by sport’s key stakeholders if they are serious about staying one step ahead of the cheats.

What do you think are the greatest risks facing the sports industry in 2023 and beyond?