Published On: Mon, Mar 5th, 2018

The most famous anti-doping scientist in the world thinks we can put an end to cheating in sports. Here because.

“Biological passports” could put an end to the abuse of drugs that increase performance.

The 2018 Winter Olympics in Pyeongchang, South Korea, ended and only four athletes were arrested for doping.


It is certainly an improvement compared to the 2014 Winter Olympics in Sochi, where Russia has managed a massive doping program sanctioned by the state for its athletes, has been captured and has been deprived of 13 of the 33 medals won.

The scandal was highlighted in the Netflix documentary Icarus, in which the Russian director of the anti-doping laboratory transformed the informer Grigory Rodchenkov into the display of the sophisticated apparatus behind the fraud. The film won the Oscar for best documentary on the weekend.

Yet the four athletes captured this year remember that the pressure to cheat is still there. And it is becoming more intense as technology advances and stakes become higher in international competitions. “Doping appears to be widespread among elite athletes, and remains largely uncontrolled despite current biological tests,” write the authors of a study by the World Anti-Doping Agency of 2017 (WADA).

Anti-doping officials like Olivier Rabin, however, are convinced they can win. Rabin has led the scientific division of WADA since 2002 and believes that the best tests in the future will be able to eliminate doping. Even with the advent of new technologies such as brain stimulation, doping tactics such as micro-dosing and nefarious government conspiracies, tools such as biological passports could make promoters of illegal performance a non-determinant factor in future competitions.

A slightly modified version of our conversation follows.

Umair Irfan
I’m sorry, first. It seems that the line has been confused and therefore disconnected.

Olivier Rabin
We hope not to be registered by the Russians.

Umair Irfan
So you really think we can stop doping?

Olivier Rabin
Well, if my answer to your question was no, I would not be at WADA. I’m one of the people who believes that yes, we can probably get to that point.

There will always be new substances coming, but if we are proactive enough to receive all the information from the pharmaceutical and biotechnology industries for new drugs with a potential for doping … if we can access very quickly all the illegal drugs that are released around the world almost every week, it’s just a question of resources.

It is not that we do not know what to do; is that we need to do it on a sufficiently large scale.

If you look at the Pyeongchang Olympic Games, the leading medal nation was Norway, and Norway has a very good anti-doping agency and a lot of their athletes. So it shows that you can compete and you can win with good anti-doping programs in your country.

So I think there are many challenges to come, but yes … I really think we can get to a point where the impact of doping in sport would be absolutely negligible.

Umair Irfan
It is interesting that you have raised Norway because there have been some questions about Norwegian athletes who have misused the therapeutic use exemption for asthma medications, which can also serve as performance enhancers. Their Olympic team went to Pyeongchang with 6,000 doses of asthma medications. It seems strange.

Olivier Rabin
Asthma is quite common in some sports and in some countries. And when we talk about the athletic population, people competing in cold and dry air are more susceptible to the development of physical activity-related bronchoconstriction.

Asthma is not unusual, let’s say so. We have developed our research into asthma and asthma treatment drugs, and we have no indication today that when taken at an inhaled therapeutic dose, these drugs can provide athletes with any performance enhancing effects.

We have been involved in some cases where we thought the drug was not used properly. And if necessary, this can lead to the sanction of athletes wherever they are in the world, in Norway or elsewhere.

Umair Irfan
Do we know to what extent the prevailing doping is in general? I have seen several estimates, including an anonymous WADA survey which found that anywhere between 43% and 70% of athletes used banned substances in various international competitions.

Olivier Rabin
It’s a good question First of all, when I say “prevalence”, it should probably be “prevalence” because we have the indication that the prevalence of doping varies according to sport and according to the country.

You have sport with potentially quite high doping [cycling, weightlifting], a few percentage points and several sports in the same country with an extremely low prevalence of doping [archery, ping-pong]. In that situation, it is not related to the country, it is related to the discipline.

And then you have countries, Russia is one of them, where the manipulation can be high and the prevalence of doping is probably high. A publication of the [International Association of Athletics Federations, the governing body for athletics] in 2011 found that the prevalence of athletics varies widely from country to country. Probably from discipline to discipline.

There is no simple answer to this, and that is why at WADA we are now working with a group of experts to develop tools that could be put in the hands of anti-doping organizations to better assess the prevalence of doping in their country or their sport.

Umair Irfan
As new drugs are developed and more substances are added to the banned list – there are more than 300 hours – it seems that anti-doping screens are becoming increasingly difficult.

Is the goal of screening for everything, or are you more strategic about the test?

Olivier Rabin
You are right. It is always a challenge to have hundreds and hundreds of substances to analyze and the sensitivity of the methods you apply. Of course, we have to develop strategies and those strategies are guided by our colleagues in other departments. Let’s take an example, the abuse of EPO could potentially be more prevalent or more beneficial for athletes [in cycling and in athletics]. So in those sports we need to have a higher rate, a higher percentage of samples tested for EPO.

Obviously in some other sports where the use of EPO is less problematic – think of chess, think of curling for example – you might want to reduce the percentage of samples analyzed for EPO. Do some EPO analysis but you do not do it as frequently as for other endurance sports.

Umair Irfan
How do you handle institutionalized deception, like the one we saw with the Russian government manipulating test results in the lab?

Olivier Rabin
First of all, since you could follow the Russian dossier from the beginning, you may have seen that one of the first concrete actions taken by WADA was to suspend the laboratory and then to revoke it and then ask the laboratory director for the time is he was basically fired.

This is the authority we have in anti-doping laboratories. It was a lesson learned by everyone that, of course, a laboratory that is part of the anti-doping system can trick the system with different strategies. Even though we started to have suspicions, we had to go from suspicion to evidence, evidence that we could use before a court, which we obviously did now.

In 2012, we did two things that I think are very important: we received the authority to investigate the new version of the WADA anti-doping code. A case like that to which we refer to the investigative power required that we now have.

The second element now present is what we call the international standard for compliance. In the past, WADA had no authority when a country, sport or other bodies such as a government or an international organization did not comply with the anti-doping rules set out in the World Anti-Doping Code. This has changed now. We have an international standard that allows us to investigate, but also a sanctioning mechanism for countries that do not comply.

Umair Irfan
It seems that athletes are increasingly looking for ways to improve mental performance or drugs that act on the central nervous system. Clearly, drugs like amphetamines are banned, but there seems to be a gray area with drugs like caffeine and some new twists with tactics like transcranial direct current stimulation. How does WADA handle this type of drug or strategy?

Olivier Rabin
So there are still new stimulants that we add to the list. They are by definition forbidden, but when we see new lawyers arrive, we identify them and make their identification a variable to be shielded in anti-doping laboratories.

Now, if you talk about transcranial stimulation, this is something that our group of experts has examined and are not convinced at this point that there are some measurable improvements in performance with this approach. We follow the literature very well, and if we look at transcranial stimulation, some studies are very controversial and we still need this methodology to show that it is effective.

Some people believe it is, other people are very doubtful. It is also applied in a medical setting and we have followed some of these studies conducted for clinical applications of transcranial stimulation. And again, the results are not clear.

So, before jumping the gun and saying that this is absolutely forbidden, we need to have some level of scientific and medical evidence to say it. The code requires us that a prohibited method has the potential to improve performance, is a risk to athletes’ health and potentially violates the spirit of sport. For now, transcranial stimulation does not meet these criteria.

Caffeine has been the subject of much debate with our group of directory experts. The fact that caffeine is widely available shows that it can not be considered a health risk, even sometimes there are studies that show the opposite. So far WADA has decided not to include caffeine in the list of prohibited substances and methods.

Umair Irfan
I was really interested in the use of the athlete’s biological passport as a tool to detect betrayal in sports such as cycling and athletics, monitoring the values ​​of individual biomarkers over time that could signal improper play. It seems that he is changing the burden of proof from the anti-doping authorities to find cheating for athletes who now have to prove they are clean.

Can you tell me about the logic behind this approach?

Olivier Rabin
Having been intimately involved with the passport at the beginning of 2002-2003, I think there are two important things to keep in mind. The first is that you are not using a reference population or a reference range population to establish a value.

Now, with the passport, we have moved from a reference range population to your values. This reduces the variability of the human population.

The second element that comes into play is that we take values ​​over time and use what we call the adaptive model. It allows us to predict what your next value should be if you do not manipulate your biology or take doping substances.

Usually we need to have two or three values ​​to establish a good base of reference for the different variables, the different biomarkers. And some of the athletes are tested dozens of times each year.

When all these elements are developed and well integrated, some of us believe that it will be very, very complicated for athletes to take drugs, or if they do, they will do it at such a low level that the impact on their performance is likely to be negligible.

Umair Irfan
Have you started to see the effects of a biological passport? And an athlete could play the passport? Athletes can microdose with a performance boost over time, so their baseline is high?

Olivier Rabin
Today, the athlete’s biological passport, and especially the haematological module, has led to a huge difference in terms of impact on blood variables. There have been very good data collected from some federations that show the normalization of the blood variables of the population of athletes compared to normal values ​​in certain populations.

With a normalization of blood values ​​over time, we have shown that athletes are less likely to manipulate.

Let’s think about the EPO microassay. It is something that we have integrated into the development of the ABP hematology module at the beginning. Some of the studies we conducted were conducted with microdosing.

Now, we are not naive to the point where we believe we have uprooted blood doping. We are constantly perfecting the passport, the biomarkers and the variables we include in the passport to make sure this is a very strong tool that will last for years.

Leave a comment

XHTML: You can use these html tags: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>