It has been yet another tumultuous period for the World Anti-Doping Agency (WADA). Firstly, Dr. Grigory Rodchenkov – the former Director of the Moscow anti-doping laboratory who admitted destroying 1,417 samples he was asked to retain – alleged that doping samples of Russian medal winners had been manipulated at the Sochi 2014 Winter Olympics. The allegations included that four Russians on steroids had taken gold at Sochi.

Secondly, the International Olympic Committee (IOC) announced that ‘up to 31’ athletes due to compete at the Rio 2016 Olympics had doped. The findings came from retests of 454 samples taken at the Beijing 2008 Olympics and involved athletes from six sports and 12 National Olympic Committees (NOCs). Even worse, more positives could be in the pipeline, as the IOC is retesting 250 samples from the London 2012 Olympics. Likewise, if adverse analytical findings (AAF) are confirmed for medal winners, the total could rise as medal reallocation would require further retests.

The IOC later clarified that we will have to wait until June to see if the retests involve an AAF, which is why it could only confirm that ‘up to 31’ athletes had tested positive. We are still awaiting analysis of their B samples. An AAF is only confirmed if analysis of the B sample matches that of the A sample.

Although the allegations involve the Olympics, WADA has once again been called upon to investigate. It has experience in this area, having produced two reports into allegations of systemic doping in Russian athletics. Heading the Independent Commission formed to investigate these allegations was Dick Pound, WADA’s founding President. The Sports Integrity Initiative spoke to him at the recent Sports Resolutions conference, which took place before the Sochi ‘bomb’ went off, about the tools that he would like to tackle doping in sport.

Investigation costs

Investigating doping is an expensive business. At its Foundation Board meeting in November last year, WADA revealed that its two Independent Commission reports into allegations of systemic doping in Russia had cost US$1.3 million. That is around 6% of WADA’s $21.2 million budget for 2016.

With funding for anti-doping in the news, a breakdown of WADA's income and expenditure since 2003 #doping pic.twitter.com/NhBHc67kQO

— Leigh Thompson (@Leigh_DT) May 14, 2016

As the above illustrates, WADA’s expenses are currently outstripping its contributions. If it is to be required to carry out such investigations, it will need more funding. Pound has a solution for this – make those being investigated pay.

“WADA needs additional powers to investigate, as well as the power to make those being investigated contribute towards the cost of that investigation”, he told delegates at the Sports Resolutions conference. “We also need the power to sanction those who refuse to contribute”.

This expanded on a theme developed at the Tackling Doping in Sport conference earlier this year, where he said: “You need to do something to get their attention. You would say that we have enough information that our internal review committee thinks there’s probable cause. We think that it’s going to cost a million dollars. We think it’s appropriate for you to pay half. Upfront. And if you don’t pay that in whatever the time is, then you can impose a provisional sanction.”

WADA President Sir Craig Reedie has recently suggested putting a 0.5% tariff on media rights, which he estimates would raise $175 million for WADA. However, Pound pointed out that this may require changing WADA’s funding model. Under the current system, the IOC is required to match funding provided by governments which means that in practice, WADA must ask governments to increase funding in order to increase its budget.

“One of the policy decisions that could be made is that instead of taking half of $26 million each year, we could double that – simply take it off the television revenues”, he said. This would involve no change to the contributions required by governments and the IOC, but would require broadcasters and companies sponsoring sport to match the $26 million jointly provided by governments and the IOC.

However, Pound warned that this model still faces the ultimate problem that the Agency must go, cap in hand, to governments in order to secure any funding increase. “You should see the war dance they do on every half percent increase”, he said. “This is, for them, $13 million spread over 205 countries. It’s not even a rounding error. However, you’d think civilisation as we know it would disappear if we had to pay any more.”

“The whole philosophy was that sport would pay half and the federations would pay half”, he continued. “You would have to get their consensus. My experience is that you can’t embarrass governments. Especially not across that board. So we have to try and find some way of getting them to the table.”

Meldonium

Recent developments regarding Sochi 2014 and IOC retests have taken the focus away from meldonium. Critics – such as the manufacturer of the main meldonium brand, mildronate – argue that WADA should never have added the substance to its Prohibited List, as there is no scientific evidence that it has a performance-enhancing effect. There is, however, evidence from WADA that athletes were taking it.

According to Article 4.3.1 of the 2015 World Anti-Doping Code, a substance must meet two of three criteria to be included on the List:

• Medical or other scientific evidence, pharmacological effect or experience that the substance or method, alone or in combination with other substances or methods, has the potential to enhance or enhances sport performance;
• Medical or other scientific evidence, pharmacological effect or experience that the use of the substance or method represents an actual or potential health risk to the athlete;
• WADA’s determination that the use of the substance or method violates the spirit of sport described in the introduction to the Code.

Mildronate’s manufacturer Grindeks argues that meldonium is used to treat health conditions such as cardiovascular and neurological diseases. If it doesn’t have a performance-enhancing effect and it designed to promote health rather than posing a risk to the health of athletes, then Grindeks’ argument that it shouldn’t be on the List appears to hold some water.

However, Pound doesn’t support the theory that in meldonium’s case, WADA got it wrong. “In the sense of identifying it as a drug to go on the list, the scientific process we go through and the consultation is huge, on an annual basis”, he argued. “There was a very clear consensus that it should be on the List”.

In April, WADA said that there have been 172 positives for meldonium since the 2016 Prohibited List, which banned meldonium, was introduced on 1 January. Many of these athletes have argued that they stopped taking the drug months before the List came into effect. As WADA’s Guidance Notice on meldonium indicated, it appears that the detection window for the drug is much longer than previously thought.

The only known scientific study on excretion times for meldonium was published on 4 May this year. The study, which was performed on ‘two healthy male volunteers’ (not elite athletes), found that meldonium exited the body in two phases – a rapid phase followed by a slower elimination phase. It could provide some support for athletes who have tested positive for meldonium, but claim to have stopped taking it before the 2016 Prohibited List came into effect on 1 January.

‘According to literature data, the estimated half-life (t1/2) of meldonium during the initial rapid elimination phase is 5–15 h’, it reads. ‘The results of this pilot study suggest the existence of a subsequent second and substantially slower elimination phase, attributed to a proposed incorporation of meldonium into erythrocytes. The administration of a single oral dose of meldonium was detected in human urine for up to 49 days using established doping control analytical approaches and in DBS for at least 16 days. In consideration of the multi-dose administration data and reported accumulation effects regarding meldonium and the aforementioned results that suggest the incorporation of the drug into erythrocytes allowing for sustained liberation during eryptosis, detection windows after long-term administration of high but yet therapeutic amounts of meldonium span over several weeks and might even extend to months.’

“It would probably have been better to have done those studies in advance”, conceded Pound. “Looking back with the clarity of hindsight, that would have been helpful. Once you knew you are heading towards a recommendation to add it to the List, somebody should have said OK, is this like marijuana, where it stays in your system for weeks or whatever the duration is, or is it something that is gone pretty quickly.”

Communication issue

WADA has already said that it will look at how international federations are communicating changes to the World Anti-Doping Code, after Maria Sharapova fought back against allegations that tennis authorities had warned her five times about meldonium. “In light of what we see, the communication might not have been optimal at that level”, said WADA’s Chief Operating Officer and General Counsel, Olivier Niggli. ““Clearly there is a responsibility on anti-doping organisations to make sure that they pass on the information”.

Pound said that WADA would consider making communicating changes to the Prohibited List a compliance feature of the Code. “We can probably do that”, he said. “One of your Code compliance checklists would be what do you do with respect to the annual List and changes to it? Or, have you communicated it to the athletes? You can certainly put an onus on the international federation to make sure its national federations do this; on the NOC to make sure that its national federations do it. That’s certainly feasible.”

Russia – double standards?

On 17 June in Vienna, the International Association of Athletics Federations (IAAF) Council will decide whether Russian athletics has made sufficient changes to be readmitted, ahead of the Rio 2016 Olympics. One criticism that has been aired is that given the weight of allegations against Russian sport, any decision to readmit Russia runs the risk of being viewed as double standards, given that the International Weightlifting Federation (IWF) has banned Bulgaria after 11 of its weightlifters tested positive in March 2015.

Pound said that Bulgaria was banned under a weightlifting rule introduced after the 1988 Seoul Olympics due to the number of positives being produced by the sport. “Weightlifting did a number of things”, he clarified. “It changed all of its weight categories and previous world records. They imposed very strict provisions including a cumulative number of positives leading to disqualification of your team. They introduced fines, which were US$50,000. I said that doesn’t seem that significant, but look at the countries where this is happening. It could be all of the foreign currency reserves in the country. The current expulsion of Bulgaria arises through the application of that rule. The IAAF doesn’t have such a rule – in fact, no other federation has that rule.”

Pound said that WADA would consider making such a rule mandatory for international federations in the next consultation round on potential changes to the Code. “It is possible”, he said. “During the next go-round of the Code, we ought to say that all signatories ought to have such a rule that is reasonable in the circumstances”.

Russian ban – unfair for clean athletes?

IOC President Thomas Bach has recently said that he is keen to explore whether athletes from ‘contaminated’ federations could still compete at the Olympics, if they can prove that they are clean. Pound isn’t keen on such a proposition.

“If Russia is guilty and doesn’t talk its way back in, then it’s absolutely correct that they are not in”, he argues. “It may be unfortunate that there are other countries that have not yet been caught, however, as I understand it, Seb[astian Coe] has put six or seven other countries on a watch list, certainly the other ones that we mentioned in the [Independent Commission] report, for that reason. You may get to the point where you can put them on some sort of a timeline where they have a positive obligation to demonstrate that they are clean, rather than the IAAF having to establish that they are not. I think that there are a number of ways that you can slice the pie to increase the pressure.”

Sport investigating sport

Interestingly, Pound recognised that sport has not done a great job at investigating systemic doping and may face evidential problems if it attempts to investigate other countries. “Our Commission was lucky to have really good whistleblower evidence, really lucky. It was well organised, it was sound, it was un-impeachable, we did all the forensic analysis of the tapes and determined that they hadn’t been altered and so on. However, if we had gone to Russia without that evidence, we would have been told to go home.”

Pound also said that while WADA is ready to look at other countries, its investigative capacity has been hampered by the loss of Jack Robertson, a former US Drug Enforcement Administration (DEA) agent who worked with the US Anti-Doping Agency (USADA) on its investigation into Lance Armstrong. “WADA is ready to look at sports in other countries”, he said. “Whether they will take another chance with me or not, I don’t know. The investigation mechanism should work and we’re building up our own little forensic unit within WADA. We lost Jack Robertson to a combination of illness and retirement relatively recently. We’re trying to replace him so that we have an in-house investigative capacity.”

Whether Robertson retired or was fired for sharing some of the conclusions of the Independent Commission’s second report ahead of its publication is the subject of some debate. “Quebec law does not allow us to discuss the details of personnel publicly”, said a WADA spokesperson.

Pound has met with the IOC Athletes Commission and has encouraged it to get involved. “We said to the Athletes Commission: You guys are out there. You know what’s going on. Tell us what kind of protection you need in order to encourage people to come forward. You can’t do that sort of thing in Russia – as we know. It was so bad. ARD was very good about that. They said look, we’re not going to run this programme until you’re out of the country and hidden away. Think about that.”

“The sports federations, as you heard in the panel are just brutal with whistleblowers, absolutely brutal”, he continued. “So there has got to be a way of getting the evidence and then…well, you’re all journalists. If you have certain information, then you go and speak to others, they don’t know what you know, so you’re able to cross check what you know with what they say.”

Readmitting Russia

“At the moment, they’re on the outside trying to get back in”, points out Pound. “So there’s an onus on them to show that whatever changes are required have indeed been effected”. This was already a hard task, which has been made even more difficult by the allegations surrounding Sochi. Currently, only athletics has been suspended but, as pointed out by UK Athletics CEO Ed Warner, the suspended Russian Anti-Doping Agency (RUSADA) and the Moscow laboratory were not just responsible for testing track and field athletes.

So has Russia reformed itself? UK Anti-Doping’s experience in managing a testing programme within the Russian federation would suggest not. Following meetings with WADA and RUSADA last year, UK Anti-Doping (UKAD) officially accepted a mandate to assist with testing Russian athletes on 18 December.

Its experience has not been a roaring success. It only managed to conduct 247 tests from 18 November 2015 until 5 May 2016. A planned 426 additional tests were ‘cancelled/declined’. Based on the 247 that were conducted in that period, 99 involved whereabouts failures across 18 sports; there were 20 missed tests; 79 filing failures; one whereabouts violation and one refusal.

The full ‘Status of Russia testing’ document (see below), which was presented to the WADA Executive Committee and Foundation Board meeting on 11/12 May, also details the issues that UKAD has encountered with testing athletes in Russia. It lists:

• Capacity of private sample collection companies limited in Russia;
• Delayed payments from RUSADA to UKAD, private sample collection providers and international experts;
• Delayed agreements for experts; and 
• Issues with access to closed cities.

This presents a problem for the IOC and WADA, as it suggests that it is not only Russian athletics that has an issue. The whole of the Russian testing regime has yet to reform, meaning that there could well be athletes competing in Rio who have not been properly tested, out-of-competition. This destabilises Reedie’s claim that there ought to be a way for athletes who can prove that they are clean to compete in the Olympics. It would be very difficult for a Russian athlete to prove that they have been properly tested in such circumstances.

“On balance, I think that from a system point of view, it would be nice to have everybody at the Games”, said Pound. “Whether that makes sense or not – given what will be found in terms of the evidence of the changes they have actually made, remains to be seen”. And therein lies the problem. Under current circumstances, admitting Russian athletes to the Olympics would require them to prove that they are clean. The evidential burden of doing this could prove just too difficult.