27 October 2017

WADA 2016 Test Figures P2: Mexico top lab in terms of AAFs

Mexico City’s Laboratory reported the highest proportion of adverse analytical findings (AAFs) as a percentage of the samples it analysed for the second consecutive year, analysis of the World Anti-Doping Agency’s (WADA) 2016 Anti-Doping Testing Figures Report has shown. The 120 AAFs recorded at the Mexico Laboratory were all a result of urine rather than blood samples, and represented 7.13% of the 1,684 samples taken outside of the Athlete Biological Passport (ABP) programme. ABP samples taken by the laboratories are included, but outside of the sample totals since they are not designed to return an AAF, but are monitored over time to detect variations in blood values that could indicate doping.

The figure is even higher than the 146 AAFs from 3,559 samples (4.1%) that the Mexican laboratory reported in WADA’s 2015 Report. WADA suspended the Mexico Laboratory on 23 November last year for a period of up to six months, and has since extended that suspension for a further six months ‘to address outstanding non-compliances’.

WADA’s statement said that the suspension was ‘a direct result of the more stringent quality assessment procedures enacted by WADA to ensure laboratories maintain the highest standards’, but did not go into specific details. However, it is understood that the suspension was a direct result of the reporting of a false modafinil positive in the case of Paola Pliego, a fencer who missed the Rio 2016 Olympics due to the error.

US sports

The highest total number of AAFs during 2016 was recorded by the Montreal Laboratory, which reported 469 – 146 of which were reported inside WADA’s Anti-Doping Administration and Management System (ADAMS), and 323 of which were reported outside of ADAMS. The US laboratories reported analysis of large numbers of samples outside of ADAMS because they are responsible for testing the US professional leagues (e.g. the MLB, NBA, NFL), which are not signatories to the World Anti-Doping Code.

As reported by The Sports Integrity Initiative yesterday, WADA’s figures show that blood tests are not resulting in AAFs. Of the 17,306 blood tests carried out by laboratories entered into ADAMS, just 28 (0.16%) resulted in an AAF. The Cologne Laboratory analysed 3,271 blood tests during 2016, resulting in just two AAFs. The London Laboratory analysed 1,187 blood samples to report just one AAF.

In the US professional sports leagues, the situation regarding the ineffectiveness of blood tests appears even worse. A total of 5,992 blood samples were analysed by the three North American laboratories outside of ADAMS during 2016, without a single atypical finding (ATF) or AAF being reported.

According to the laboratory figures, the North American sports return a higher percentage of AAFs as compared to samples analysed. Of 71,051 samples analysed in 2016, 1,790 resulted in an AAF (2.52%). This compares to 1.32% of analysed samples returning an AAF for samples analysed under the jurisdiction of the World Anti-Doping Code.

The African problem

Africa remains a problem in terms of sample analysis. For almost a year, African countries have been without a laboratory that is accredited by WADA to analyse athlete samples.

On 30 June this year, WADA extended the suspension of the Bloemfontein Laboratory, which was initially suspended on 3 May 2016. The South African Laboratory’s accreditation for testing blood samples was temporarily reinstated in August 2016, but not for urine samples. This put pressure on African ADOs to either send samples abroad or pay for more expensive – and less effective – blood tests.

The situation was compounded on 14 November 2016, when WADA suspended the Doha Laboratory, where many African countries had been sending their samples due to the suspension of the South African Laboratory. Fortunately, WADA was able to reinstate the Doha Laboratory in April this year.

The South African Institute for Drug Free Sport (SAIDS) spoke about the extraordinary measures they had to go to in order to get their samples analysed. “There is a global network of WADA-accredited laboratories and we will use those that are the most cost-efficient”said its CEO, Khalid Galant. “This means that the turn-around time of results might be affected by a few extra days because of longer transportation times, but the accuracy of testing will not be compromised”.

An additional risk for ADOs is that in that having spent the money to send a sample abroad for analysis, it could still be rejected by the laboratory on arrival. ‘If a Sample’s integrity or identity may have been compromised during transport, the Sample Collection Authority shall check the Chain of Custody, and the Testing Authority [Laboratory] shall consider whether the Samples should be voided’, reads Article 9.3.5 of WADA’s International Standards for Testing and Investigations (ISTI).

It is understood that in Africa, SAIDS is considered well-resourced. Questions remain as to whether anti-doping organisations in other countries were able to implement similar measures.

Variation

It is interesting to look at the variation in figures relating to samples analysed by the laboratories. The Cologne Laboratory’s analysis of 22,514 samples eclipses the entire number of samples analysed in Latin America (15,514), despite 2016 being the year of the Rio Olympics.The number of samples collected in Asia (36,683) was only marginally more than the number collected in Germany by the Dresden and Cologne laboratories (33,869).

Black spots

The figures reported by the laboratories underline that there are black spots in the anti-doping testing system. Athletes in developed nations often complain that they are tested more rigorously than athletes in developing nations. As had been outlined above, this is reinforced by the geography and regulation of laboratories under the World Anti-Doping Code.

Anti-doping testing is expensive. If you are an athlete in a developed nation, you are more likely to be close to a well-resourced testing authority that has access to a nearby laboratory, which is also well-resourced. Conversely, if you are an athlete in an underdeveloped nation, it is more likely that your testing authority will be under-resourced and you are more likely to be further away from a well-resourced laboratory.

In turn, that testing authority is unlikely to be able to spend large amounts of money on testing missions. Faced with the risk that a sample might be rejected by an overseas laboratory, many ADOs could be forgiven for deciding not to bother in order to save money. Even if there is a local laboratory, lack of resources may mean that it is more prone to mistakes, which can result in WADA suspension.

The laboratory figures also underline that blood testing may be an expensive and ineffective deterrent to doping. Urine tests are cheaper and appear to return more AAFs. In an era when anti-doping organisations complain about underfunding, a move away from blood testing may be worth considering to save money.

Analysis of the laboratory testing figures appear to show that the gaps in testing highlighted above are more likely to arise in Africa, Asia, or Latin America. A significant issue with the regulation of laboratories is that under the accreditation system created by WADA, there is little choice other than to suspend a laboratory that is not performing as it should. As we have seen in Russia and Africa, this only compounds the problem. A solution is needed.

• Analysis of the WADA 2016 Anti-Doping Testing Figures Report by Sport is available here. Analysis of the most common substances to return an AAF is available here.

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