Science & Society

Doping and drug testing Anti-doping work must be transparent and adhere to good scientific practices to ensure public trust

Erik Boye1,2, Tore Skotland1,3, Bjarne Østerud4 & Jon Nissen-Meyer2

port plays an important role in society: substances through rules set down in its evaluation of the laboratory’s conclusions. It is a major social and economic code, which is signed by most countries. The irregularities of this case have also been S activity, it contributes to public health, However, it remains a problem that violators discussed elsewhere [3,4]. it is entertainment, and achievements in can use illegal drugs, yet avoid being caught We believe that the data and the conclu- amateur and professional sports are sources for doping, and therefore, athletes can some- sions from the CAS would never have been of motivation and pride. In popular sports, times win by unfair means. At the same accepted by a peer-reviewed scientific publi- the rewards in the form of prestige, fame time, it is important that the net to catch cation for two reasons: First, the methods and revenues can be significant. Some violators is not too fine—that attempts to used were not reproducible and the results, athletes are therefore tempted to cheat and increase the sensitivity of the test methods obtained by two different methods, were not use performance-enhancing drugs, even do not undermine specificity—so that inno- consistent with each other [1]. Second, the when it may seriously threaten their health. cent athletes are accidentally caught. To data therefore do not support the conclu- Yet, doping is not just a health issue; it is ensure correct and justifiable decisions to sions. It is troublesome that it is possible to unfair to other athletes and in complete ban athletes from competitions, anti-doping sentence an athlete based on inconclusive opposition to the idea of competitive sports work must adhere to the best scientific stan- evidence under a varnish of objective that the best shall win in a fair contest. dards for producing evidence. The work science. Furthermore, data used for a must be of indisputably high quality so that conviction in court should be scrutinized ...... the results are seen as scientifically sound even more thoroughly than data published “...doping is not just a health and procedurally legitimate. Below, we in scientific journals, since the consequences discuss cases where two WADA-approved can sometimes be dramatic. issue; it is unfair to other laboratories have demonstrated a lack of athletes and in complete adherence to good scientific practice, with ...... opposition to the idea of serious consequences. “To ensure correct and competitive sports that the best justifiable decisions to ban An irregular case shall win in a fair contest.” athletes from competitions, ...... In 2011, Erik Tysse, a speed walker from anti-doping work must adhere Doping in sport is illegal. Most govern- , was sanctioned for using the drug to the best scientific standards ments have signed a UN convention against CERA—an analogue to EPO—and his appeal for producing evidence.” doping, but some are rather lenient or negli- was rejected by the Court of Arbitration for ...... gent in their attitude. For many countries, Sport (CAS). As we have documented else- achievements in sport are closely tied to where [1,2], the data presented by the We have for several years tried to obtain national pride, and the temptation to use WADA-approved laboratory in Rome lacked information and documentation that could prohibited methods can therefore be rigour, quality and reproducibility. Impor- help explain the inconsistent results stronger than respect for the rules or tantly, after three analytic tests of the same presented by the Rome laboratory—from concerns about the health of athletes. urine sample that yielded incompatible both the International Association of Athlet- Anti-doping regulations based on strong results, the WADA laboratory incorrectly ics Federation (IAAF) and WADA. In partic- scientific and legal principles can therefore interpreted the images as positive and ular, we have asked for the original data and help to prevent abuse and ensure fair presented manipulated image data as a copy of the laboratory report in which contests for athletes in all disciplines. evidence for the CAS. Our two publications important information had not been masked, The World Anti-Doping Agency (WADA) [1,2] present and describe the data from the which was the case for the hearing before regulates the use of performance-enhancing laboratory in Rome along with our detailed CAS. Neither WADA nor IAAF have

1 Institute for Cancer Research, Oslo University Hospital, Oslo, Norway. E-mail: [email protected] 2 Department of Biosciences, University of Oslo, Oslo, Norway 3 Centre for Cancer Biomedicine, Faculty of Medicine, University of Oslo, Oslo, Norway 4 Institute for Medical Biology, UiT, The Norwegian Arctic University, Tromsø, Norway DOI 10.15252/embr.201643540

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answered our pleas, let alone released the k.com/steven-colvert-epo-world-anti-doping- (https://www.wada-ama.org/sites/default/ requested information, which is essential for agency-sport-509189). The A- and B-Sample files/resources/files/20160718_ip_report_ an independent evaluation of the analytic Analytical Reports and the Hearing Tran- newfinal.pdf; https://www.wada-ama.org/en/ tests. One response, though, was a letter script on which his conviction was based resources/doping-control-process/mclaren- from the WADA-approved laboratories to have been published on his own web page, independent-investigation-report-part-ii). commercial companies that had advertised stevencolvert.ie. There seems to be no According to a number of independent in Lab Times, which published our findings. disagreement between us and WADA about reports, the Russian athlete Yulia Stepanova The implied message was that WADA- the factual basis for our arguments, but the and her husband Vitaly warned WADA in accredited laboratories—who made sure to interpretations differ significantly. The entire 2010 about doping among ’s Olympic note that they were good customers of these case rested on an interpretation by the athletes and that the government and the companies—would consider not buying WADA-approved laboratory in Cologne that Russian anti-doping agency were complicit. equipment from them in the future if they, a slight tailing or spreading of the bulk of They supplied WADA with evidence through the companies, continued to advertise in the the EPO detected in their SAR–PAGE analysis hundreds of emails. The Stepanov family is journal [5]. There is no doubt that the recipi- (modified SDS–PAGE) of Colvert’s urine now in safety somewhere. In 2012, the ents and the journal interpreted this letter as was caused by rEPO. This tailing is not at Russian athlete Darya Pishchalnikova was threatening. all obvious and not much different from reported to make similar approaches to that observed in parallel lanes where the WADA and gave them revealing information...... urine of athletes deemed to be free of rEPO This is her story, in short, as described in “It is troublesome that it is had been used. The WADA laboratory The New York Times: “Darya Pishchalnikova argues that, in order to identify a positive had won a silver medal 4 months earlier at possible to sentence an athlete sample by this method, one needs to be an the Olympics. She said that she had based on inconclusive evidence expert with a long experience. The labora- taken banned drugs at the direction of under a varnish of objective tory referred to their own experts who Russian sports and anti-doping authorities science.” could, presumably, separate a positive from and that she had information on systematic ...... a negative sample in situations where most doping in her country. Please investigate, she people could not see a difference [7]. The implored the agency in the email, which was Another response is statements by repre- Cologne laboratory’s experience in inter- written in English. I want to cooperate with sentatives of WADA laboratories that they preting such gels was deemed sufficient by WADA, the email said. But WADA, the have an ethical code that prohibits them the court, even though the method was global regulator of doping in Olympic sports, from responding to external parties. We neither reproducible nor quantifiable and did not begin an inquiry, even though a staff agree that WADA laboratories do need a the criteria are not formally documented to lawyer circulated the message to three top code of ethics, but we have not been able to allow independent verification. officials, calling the accusations ‘relatively obtain a copy of such a document, which It is particularly relevant to review the precise’, including names and facts. Instead, allegedly prohibits scientists in WADA- following statement from CAS in 2001: “A the agency did something that seemed anti- accredited laboratories from discussing their sample cannot be declared positive or nega- thetical to its mission to protect clean work with the scientific community. It is not tive depending on the subjective opinion athletes. It sent Ms. Pishchalnikova’s email easy to understand how such a ban on and/or experience of the laboratory staff to Russian sports officials—the very people communication, which jeopardizes the rule according to the maxim ‘I know it when I who she said were running the doping of law for the athlete in question, can be see it’. Rather, it is imperative that the labo- program”. In April 2013, she was banned by rooted in a code of ethics. Furthermore, a ratory applies reliable and verifiable criteria, the Russian Athletics Federation for 10 years code of ethics should not condone the making it possible for third parties to objec- (http://www.nytimes.com/2016/06/16/ writing of a threatening letter to companies tively understand the conclusions reached” sports/olympics/world-anti-doping-agency- that advertise their products in a scientific (http://jurisprudence.tas-cas.org/Shared% russia-cheating.html?_r=0). journal. 20Documents/343.pdf). This statement is ...... clear, correct and commendable. However, Interpretation of evidence in the Colvert case, the laboratory did “A dependable and robust exactly what CAS has decided is not accept- court system should provide After publishing the details on the Tysse able. Needless to say, this was an important case, we were contacted by Steven Colvert, element in the conviction of Colvert. checks and balances that make an Irish sprinter, who had been convicted of sure that controversial and using recombinant EPO (rEPO). As in the WADA and the Russian doping scandal erroneous decisions can be Tysse case, the evidence presented during revised.” the hearing in Ireland showed inconsistent It is now widely published and not seri- ...... results from the analyses performed. Our ously contested that anti-doping laborato- criticism and arguments have been ries in Russia changed and substituted Surprisingly, in spite of having been noti- described in more detail elsewhere [6] and urine and blood samples from Russian fied of a systematic abuse of the anti-doping this case has also received attention in athletes to hide that they were doping, as system in Russia as early as 2010, WADA international media (http://www.newswee documented in the two McLaren reports took no action. On the contrary, the

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WADA-approved laboratory in straddle both of these roles. Furthermore, it The prospects of successfully bringing maintained its accreditation and relationship is a worrisome aspect of the anti-doping anti-doping conflicts into the civilian court with WADA until late in 2015, at which judicial system that it is up to the accused system appear to be absent. We would point the mismanagement of the Moscow athlete to prove her/his innocence when a argue that this is an unworthy, awkward laboratory became newspaper headlines WADA-approved laboratory has tested a and untenable situation in which to worldwide (https://www.washingtonpost.com/ sample and found it positive. This princi- place an athlete. Importantly, it dramati- sports/olympics/wada-heard-of-russian-doping- ple, termed strict liability, is in conflict with cally reduces the athletes’ recourse to a in-2010-didnt-investigate-until-media-reports/ the public court system of most countries, fair trial. It is, of course, regrettable if an 2016/06/02/9ec77acc-28e7-11e6-b989-4e547 in which the prosecutor is responsible for athlete who is guilty of doping can avoid 9715b54_story.html; http://www.sportingin proving guilt. Importantly, to our knowl- punishment, but it is much worse when telligence.com/2016/07/25/exposed-the-story- edge it has not been tried whether the prin- an innocent athlete is convicted without behind-the-story-of-russia-doping-and-the-ioc- ciple of strict liability is in conflict with the realistic chances of having the case over- 250701/). It appears, therefore, that WADA European Convention for the Protection of turned. supports their laboratories even when poor Human Rights and Fundamental Freedoms. performance is demonstrated, which ques- WADA-approved laboratories are not Stronger sanctions require better evidence tions whether the results or interpretations kept accountable for the evidence they that the laboratories publish or present in deliver in court. We believe that the princi- Some argue that current doping sanctions court can be trusted. ple of strict liability combined with the are too mild and too short. This argument weight of the evidence supplied by the has its merits, since the offence is grave A matter of due process laboratories have resulted in convictions of and doping can stimulate the physical innocent athletes. Therefore, the possibility performance for many years. It is therefore Many scientific journals request the raw to challenge the evidence is essential. fair that dopers are excluded for longer data in cases of doubt to guarantee their Furthermore, it appears that a strong times than the duration of their acquired authenticity and correctness and to exclude presumption of guilt upon a positive drug benefits. But with more severe punishment data manipulation. In contrast, digitally test has removed the pressure on WADA to and longer exclusion times, it becomes manipulated data are obviously acceptable produce reliable and uncontestable results. even more important that the evidence on and sufficient in anti-doping hearings, as In our own experience, there is no room for which convictions are based is scientifi- both published evidence and material a meaningful discussion of the uncertainties cally sound and can survive challenges. presented during the hearing [1,2]. Since of scientific investigations in a hearing, Therefore, measures to improve the compe- digital manipulation of gel images may since the actual data and conclusions of the tence and the procedures of drug testing include the cutting out and realignment of relevant WADA laboratory are taken to must be installed along with instruments to individual lanes, it is obvious that even represent the unimpeachable facts of the ensure the rule of law. If the WADA and minor displacements of the lanes may matter. the sport governance institutions of the have dramatic effect on the outcome in ...... Olympic movement continue to disregard cases where minor displacement of a band common and important rules of fair treat- is taken as evidence for doping. Therefore, “But with more severe ment, the rule of law for athletes remains it is essential that the original images of punishment and longer an illusion. Information and forensic the gels are made available. If good scien- exclusion times, it becomes evidence used to convict athletes accused tific practice had been applied in the trials even more important that the of doping should be available and open to against Tysse and Colvert, much of the criticism and discussion. This is presently evidence presented should have been evidence on which convictions not the case. disregarded. are based is scientifically After this manuscript was submitted for With the current anti-doping system, the sound and can survive publication, we noted a letter published on court leans heavily on the material supplied challenges.” the home page of the society for the scien- by the WADA-approved laboratories, their ...... tists employed at the WADA-accredited results and their conclusions. The defence laboratories, WAADS (www.waads.org). is, in practice, left to argue against an inad- A dependable and robust court system This letter, authored by the society’s presi- equate legal procedure; the technical should provide checks and balances that dent, Christiane Ayotte, does not argue aspects are dominated and determined by make sure that controversial and erroneous with our scientific, legal and ethical issues the WADA experts. This asymmetry is a decisions can be revised. In the anti-doping and has been discussed by us elsewhere threat to due process. It is problematic that system, there is, in practice, no such mech- [8,9]. the anti-doping legal system allows WADA anism. After a decision by the CAS in laboratories to play two distinct roles: first Switzerland, the only further possibility is Conflict of interest as objective drug testers and also as the Swiss legal system which, with very The authors declare that they have no conflict of partisans in arbitration supplying the prose- few exceptions, has shown little interest interest, but two of them (TS and BØ) served as cution with laboratory data and interpreta- in participating in sports jurisprudence expert advice for Erik Tysse in the hearing in CAS. tions. It is fair to say that the laboratories and the chances of receiving a fair and None of the authors have received any financial have a conflict of interest when trying to objective treatment in this system are small. remuneration in these matters.

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References can-anti-doping-bodies-maintain-their-scientif questioning WADA’s credibility again: Border- 1. Nissen-Meyer J, Boye E, Østerud B, Skotland T ic-integrity-the-answer-is-troubling line Analysis. Lab Times 2016-5: 16–19 (2013) WADA-accredited doping analyses cannot 4. Pielke R Jr (2016) The edge: the war against 7. WADA (2016) Hearing transcript, p. 85 http:// always be trusted. Lab Times 2013-1: 18–23 cheating and corruption in the cutthroat stevencolvert.ie/wp-content/uploads/2016/02/ 2. Nissen-Meyer J, Boye E, Østerud B, Skotland T world of elite sport. Berkeley, CA: Roaring Transcipt.220615.pdf (2015) Problems at a WADA-accredited anti- Forties Press 8. Nissen-Meyer J, Boye E, Østerud B, Skotland T doping lab: Puzzling Discrepancy. Lab Times 5. Editors (2015) Only a few... Lab times 2015-6: (2016) EPO control in doping laboratories is 2015-5: 18–23 3 absolutely no joke. Lab Times 2016-6: 18–23 3. The Guardian (2016) https://www.theguardia 6. Nissen-Meyer J, Boye E, Østerud B, Skotland T 9. Ayotte C (2016) EPO testing in anti-doping n.com/science/political-science/2016/jul/25/ (2016) Another troubling doping case is laboratories is no joke. Lab Times 2016-6: 26–28

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