At the end of March, Cycling Weekly co-hosted with the University of Brighton a live debate on the future of anti-doping.
The event was inspired by two comment pieces, the first by sports ethics specialist Dr Paul Dimeo, who called for a revolution in anti-doping policy — a complete re-evaluation of what we mean by ‘cheating’.
In response, substance-detection specialist Professor Yannis Pitsiladis countered that current anti-doping measures can succeed provided they evolve via improved testing and more severely punitive deterrents.
Thus the debate was sparked — anti-doping: evolution or revolution?
Now, as a follow-up to the live debate, we have brought together Dimeo and Pitsiladis with Dr Roger Pielke, political scientist and author of The Edge: The War Against Cheating and Corruption in the Cutthroat World of Elite Sports, and asked them 10 questions that cut to the heart of the difficulties sport faces in eradicating cheating with banned substances.
It is a debate that raises questions of sporting integrity, scientific progress, ethics, the concept of ‘fair play’, corruption and conflicts of interest.
Highlights: doping live debate
Professor Yannis Pitsiladis of the University of Brighton is developing new genetics-based technology in an attempt to establish ‘bulletproof’ anti-doping tests.
Dr Roger Pielke, Jr. of the University of Colorado has written extensively on policy and governance in sport, and his latest book is The Edge: The War Against Cheating and Corruption in the Cutthroat World of Elite Sports.
Dr Paul Dimeo is a lecturer in sports policy at the University of Stirling. He takes a critical stance on the prevailing ‘detect-and-deter’ approach in anti-doping, and believes a policy overhaul is overdue.
1 In your personal view, how much, if any, progress has been made in the fight against doping over the past decade?
Yannis Pitsiladis: There has been significant progress in the fight against doping in sport, especially when one considers the fact that WADA is a fairly young agency — less than 20 years old. Achievements of worthwhile significance include the improved sensitivity of direct detection of banned substances and the new opportunities for real impact that come with the new WADA code that highlights education, intelligence and the storage of samples for retesting for 10 years.
Roger Pielke: There is little basis for answering this question with evidence, because we don’t have rigorous studies that focus on evaluating the performance of anti-doping efforts, nor do we have good evidence on the prevalence of doping over time among elite athletes. Recent events would suggest that the answer to this question may be ‘not much at all’, but I’d prefer evidence over anecdote.
Paul Dimeo: It depends how you try to measure improvements. There is more testing and research into new drugs and methods, but the extent to which these are making a difference remains unclear. It still seems possible for cheats to beat the system.
2 It has been estimated that around 14 per cent of current athletes deliberately take banned substances (versus one to two per cent positive tests). a) Do you think this is a realistic estimate? b) What single reform would be most effective in reducing this figure?
YP: This estimate [14 per cent] is an overestimation in some sports but an underestimation in others. Obtaining accurate prevalence data is almost impossible. The only systematic prevalence study was conducted in athletics and revealed that a third of top athletes admitted cheating during the 2011 World Championships in Daegu, South Korea. Foolproof drug-testing would be the most effective deterrent.
RP: A recent paper in the journal Sports Medicine suggested that 14-39 per cent of elite athletes that it surveyed doped. This range is consistent with a WADA study that has been prevented from being published. The first step in any effort to tackle doping should be to understand the challenge we are facing — a good first step in addressing any problem.
PD: Yes, I suspect it is realistic for certain sports, but not all — in some sports, the prevalence is no doubt higher. Sadly, I don’t think any single reform will reduce this. A complete rethink is required in how we respond to the challenge, since the current approach evidently isn’t working.
Global anti-doping annual budgets
WADA’s Total annual budget: £17-21m, 50% from IOC
UK spend: £4.5m
Rest of the world spend: £10m
3 Should the number of substances on the WADA prohibited list be reduced? What would be the effect of such streamlining?
YP: The prohibited list should be reduced to include only those prohibited substances and methods where there is evidence-based scientific support showing it benefits performance and/or causes athlete harm. This amendment would in time result in a more meaningful and enforceable anti-doping.
RP: Yes. In my forthcoming book The Edge I argue that a much simplified list, focused on those substances with significant performance-enhancing effects would aid implementation and help anti-doping agencies to better focus limited resources. I also call for a greater voice from athletes in determining which substances appear on the list.
PD: Potentially, yes, but any new list must have the backing of athletes. Streamlining might allow more athletes to stay within the rules and get better advice, but it would not be enough on its own, since the determined dopers will still focus on cheating and how to get away with it.
4 Are athletes currently being tested for banned substances appropriately in terms of protocol and frequency? How, if at all, would you change this aspect of anti-doping?
YP: No, largely because the current and ever-expanding prohibited list cannot be enforced appropriately, hence the need for a shorter, more meaningful and enforceable list.
RP: Without accurate information on doping prevalence and how it changes over time, any answer to this question would be a guess. Anti-doping needs to become much more evidence-based before we are in a position to talk about fine-tuning various approaches.
PD: There’s no easy answer. The urine test can be humiliating. Maybe a urine marker pill could be used. Blood tests are less embarrassing and less inconvenient, but the science of the ABP [athlete biological passport] is too complex for most people to understand. The current approach requires all these tests — unless we have wholesale change, we need them, and indeed, the frequency would need to increase to catch those using micro-dosing.
5 Are current sanctions for doping offences appropriately punitive? How would you change them, if at all?
YP: Current sanctions need to be more draconian in terms of duration of ban with the requirement to pay back all prize money. This would lead to greater fairness, and would function as a more effective deterrent.
RP: I recommend giving athletes a greater voice in anti-doping regulations, including deciding which substances are placed on the prohibited list, the tools use to enforce the list and the sanctioning process.
PD: The current sanctions are OK for elite athletes who have been educated and have medical support. However, I think they should be different for amateurs, minors and some low-risk sports, where certain cases of deliberate performance-enhancing doping could be treated with a two or four-year ban.
What concerns me is that cases of inadvertent doping arise because non-elite athletes do not have the same access to education and medical advice. The system is created with elite athletes in mind; there should be some flexibility for other contexts.
Doping basket cases: sport’s worst offenders
So far in 2016, there have been only three confirmed doping cases in cycling (just one at WorldTour level), putting it 10th in the list of worst affected sports.
Top of the list is athletics, which has already racked up 18 positives, one more than ice hockey, on 17, followed by swimming, with nine.
Russia accounts for by far the biggest share of doping cases so far this year, with a current total of 40.
Given that, according to WADA statistics, Russia conducts more tests than any other nation, there may be grounds for doubting the potency of testing as a deterrent.
Cycling may still have the worst reputation for doping, but — in terms of confirmed cases — it was only the fourth-worst-affected sport in both 2014 and 2015, with 16 and 21 cases respectively
Across all sports, there was a 20 per cent rise in adverse findings in 2014 (the latest year for which figures are available), with a total of 5,962, compared to 4,723 in 2013 — despite the number of tests conducted rising by only 0.8 per cent in the same period.
Figures: MPCC, WADA
6 Recent doping scandals have revealed incompetence, complicity and corruption within some of sport’s most important authorities. How big a part of the problem is this?
YP: Harmonised and effective anti-doping is extremely difficult, especially in the current economic climate. As such, the current status quo is more the result of the complexity of the problem and lack of appropriate resources than complicity or corruption within sporting authorities.
RP: This is a huge part of the problem, with no easy or obvious solution. It is an age-old question: who watches the watchers?
PD: I’m really not sure — it’s difficult to quantify.
7 At the heart of the World Anti-Doping Code is the aim to embody and preserve the ‘spirit of sport’. Is it truly feasible that athletes, coaches, officials and governing bodies across the world can unite in their interpretation and implementation of this ethical principle? If not, should this part of the code be jettisoned or modified?
YP: I do not believe the use of ‘spirit of sport’ concept adds any additional usefulness or credibility to the prohibited list, given the vastly ambiguous interpretation of this concept. The opportunity to modernise these criteria, as part of consultation during the drafting of the 2015 Code, was unfortunately lost.
RP: The ‘spirit of sport’ is a concept that reflects shared values and thus is an important one to discuss and debate. But as a regulatory criterion for anti-doping it adds ambiguity and even opens the door to a lack of accountability. Performance enhancement and health risks can be empirically evaluated, and as such should be the most important criteria under which to evaluate substances for inclusion on the prohibited list.
PD: It should probably be jettisoned, as it does not fit the ethics of elite sport. We need anti-doping policy to be logical and acceptable to all stakeholders.
8 Technical and pharmacological advances provide opportunities to cheats and the anti-doping community alike. Isn’t it inevitable that the ‘side’ with greater financial means and incentive gains (or keeps) the advantage?
YP: A proactive rather than reactive anti-doping process modernised to reflect cultural, economic and social changes is needed to readdress the balance, with fairness in sport being the primary beneficiary.
RP: Of course, but in this regard, doping is no different to other aspects of sport [where prosperity bestows advantages].
PD: Probably, yes. As things stand, this seems unavoidable.
There’s a new type of doping…
9 As genetics reveals more about the inequalities in sporting talent/potential between individuals, will perceptions around what constitutes unfairness evolve? (As a theoretical, futuristic example: genetically disadvantaged athletes could be permitted performance-enhancing drugs at specified dosages to bring about physiological parity — more equal, but fairer too?)
YP: For this reason, the aspiration for a level playing field in biological terms is at worse nonsensical and at best a remnant of the past. Instead, the focus should be on fairness in terms of all participants playing by the same and enforceable rules so that everyone has a chance to succeed — albeit not an equal chance. This is the true essence of modern-day sport.
RP: Sport is wonderful, not least because it forces us to confront such enduring questions about what it means to be human. Performance enhancement is but one battleground where such debates are waged.
Human enhancement more generally, whether through laser eye surgery, prosthetic legs or other means, offers another situation raising difficult questions. As science and technology advance, we will continue to confront such issues.
There are no enduring answers, only those temporary ones that we negotiate together; thus, the importance of open debate and discussion among all parties with a stake in sport.
PD: Inequalities have always been part of sport. I think we need to move on from romanticised notions of natural talent. But doping to gain equality is an impractical solution — it would be too difficult to measure, and too open to abuse by unscrupulous athletes and doctors.
10 Professional sport depends upon investment from corporate sponsors, many of which benefit from, if not rely on, headline-generating accomplishments by athletes, e.g. new world records. Anti-doping reduces the likelihood of such feats by limiting performance. How best to resolve, or at least mitigate, this pressures resulting from this conflict of interest?
YP: Modern and fit-for-purpose medical and scientific support of athletes could more than compensate any perceived or real benefits of doping and result in even greater performance successes.
RP: Rules that participants agree to adhere to are what make sport possible. On the field of play, we have referees to ensure rules are followed. Without rules, sport would be impossible. The governance of sport also needs ‘referees’ to help manage inevitable conflicts of interest and adherence to foundational rules.
We will never eliminate conflicts of interest, but there are better and worse ways to manage them. Fortunately, there is a large body of experience both in and out of sport to draw on to develop and implement effective mechanisms of governance. Sport hasn’t learnt lessons it should have in recent years, most notably, the failures in FIFA and the IAAF.
PD: The commercialisation seems unstoppable. But I don’t think we can have ‘pure’ sport when the rewards for athletes, their entourage and any other organisation with commercial interests are so high. At the moment, we seem to expect athletes to be clean in spite of the opportunities and pressures surrounding them.
“It’s economics, stupid”
Former pro rider and anti-doping campaigner David Millar believes the fundamental problem is a lack of conviction from those controlling the purse strings.
“Reading the answers to these questions is a great reminder that there are some very well-educated people interested in what’s happening in the anti-doping movement. It’s easy for the uneducated to be blinkered by the polemical opinions voiced on social media or published in a tabloid manner across global media outlets.
“The truth is that there are some very smart people working incredibly hard to make a difference; unfortunately, their rational responses are not widely listened to, nor decisively acted upon.
“What’s even more worrying to me is that these specialists have little power to implement what they have learnt. Theirs is a battle of little economic interest in the global sports game.
“UK Anti-Doping (UKAD) has an annual budget of £5m, which has been cut, effectively, by the UK government, which no longer covers the organisation’s WADA contribution of £500k. UKAD is left with £4.5m to monitor all sport in the UK.
“OK, we’re lucky to have as much as £4.5m to spend on anti-doping, considering the total annual budget of WADA is between $25-30m (£17-21m). You’d assume this is the grand total of the world’s nations’ contributions, but no; 50 per cent comes from the IOC — so, in fact, the whole world manages to scrape together a maximum $15m (£10m) to help build that apocryphal level playing field.
“One semi-decent Premier League footballer is worth more than that. That’s the harsh reality. The best brains in the world can’t achieve anything when they’re not part of the economic model.”