Let CAS decide (Part II)

'Let Dutee run'

There is an online petition ‘Let Dutee run’  apparently got up mainly through the efforts of Bruce Kidd, a Canadian distance runner who won medals in the Empire and Commonwealth Games and competed in the 1964 Olympics, Dr. Katrina Karkazis, a bioethicist at the Stanford University, USA, and Ms. Payoshni Mitra, an Indian researcher and activist on gender issues in sports. They are the ‘experts’ assisting SAI in fighting the case against the IAAF.

Bruce Kidd has been a campaigner against  gender rules. Dr Karkazis has been the most prolific writer among activists who have campaigned against gender verification in recent times. Her article in the New York Times ‘The trouble with too much T” elicited varied responses from the readers.

One of them wrote “So what solution should we go with - no division between men and women in competition? A three gender system? Gender self-identification as the final arbiter? A 4-tier system with testosterone tiers for both men and women? I don't know the answer but we should figure it out together.”

Testosterone debate

No matter what new studies might have revealed, as claimed, not many are prepared to believe that testosterone is not the most important factor in performance-determination between male and female athletes.

BBC Sport quoted David Epstein, award winning writer for the Sports Illustrated, USA, as saying-

"For lots of good reasons, we have decided to have a class of athletes who aren't men.

"But biological sex is not binary. That means whichever line you draw between men and women it is going to be arbitrary."

Epstein, according to the report, agrees with the IAAF's experts that testosterone is probably "the best line we can draw.” 

The question also arises whether the IAAF regulations are purely a matter of higher levels of testosterone as is being made out and insisted upon.  

The IAAF document talks of three levels of examination and investigations.  First a clinical examination, followed by endocrine (hormone) investigations, winding up with “full examination and diagnosis.”

What decides eligibility?

Does this mean you take a reading of testosterone level, find out it is way above 10nmol/L (288.18ng/dL)…voila you have a ‘positive’ case fit enough to be banned!

It surely  cannot be. Otherwise why should there be a clinical examination, and why should, for example, there be an ultrasound scan done on the athlete?

And why should a panel of doctors go through a full examination in the end before pronouncing a verdict?
There is also no explanation in the IAAF rules about intersex conditions (except for one reference) or  undescended testes producing 'functional' testosterone which could be the reason for elevated levels of the male hormones found in a woman athlete.
There is an opinion developing among critics that men also should be subjected to testosterone-level testing, not to find out doping but to determine whether some of the elite athletes could be having too much testosterone, much above normal limits which will give them an undue advantage over athletes with normal levels of testosterone.

This could be stretching things a little too far. For, no two individuals could be the same. There could be a number of genetic features that could help an athlete more than an adversary. Obviously the authorities are not attempting to lay down rules to determine classifications in normal competitions as there are in Paralympic events for example.

Male and female categories are a different matter though many people in the current debate might not agree with that assumption arguing that there are several categories of sex.

'Cut off long limbs'?

Of course there has been the comparison with long limbs, broad wingspan of swimmers and height of basketballers to point out that God-given natural advantages should not be considered as unfair or needing ‘correction’ to level the playing field. Ms. Payoshni Mitra is one among those who have argued about such advantages for certain athletes. 

SAI Director General Jiji Thomson was also quoted saying the same thing about Usain Bolt that Ms. Mitra has said in the above interview.

The argument of course is nothing new. It has been made in the past too to explain why the authorities needed to ignore the so-called advantage gained by some female athletes because their bodies produced more testosterone than normal.

Mr. Thomson has also been quoted in another report saying that SAI was opting for the second option (of appealing to CAS) since the first (treatment) may take time and there would be no guarantee that she would be back with the same level of performance.

An Olympic medal prospect?

Somehow SAI seems to have accepted this idea that Dutee could be a medal prospect at the Rio Olympics!

As pointed out by intersex activist Hida Viloria below, Dutee Chand does not figure too high in world lists either this season or last. Her 11.63s, her season best this year, ranks only 374^th in the world for the 100 metres. Her junior National mark of 23.57s for the 200m at Taipei ranks 252^nd.

Many among the readers of several articles which have by and large supported the Dutee Chand case and demanded the IAAF scrap its hyperandrogenism regulations have, however, suggested that in case women needed a separate category of competitions then perforce authorities had to draw the line somewhere or else it would be better to have ‘mixed’ competitions.

A few have also suggested that intersex athletes be allowed to compete separately. Hida Viloria, Chairperson of the Organization  Intersex International  (OII), who was in the IOC panel in 2012 to discuss the new ‘gender rules’, has however argued, in an article titled 'Stop freaking out about female intersex athletes' that the number of intersex people being limited and elite athletes among them being still fewer, there would not be much competition if a new category was to be created.

‘Gender verification’ is no longer valid and there is no mention of determining  biological sex in the rules related to hyperandrogenism. This has led to the belief that a mere rise in testosterone levels could be depriving a female athlete of the chance to compete unless she went through potentially dangerous medical treatment or surgery that otherwise would be unnecessary.

The demand that “surgical violence” in the name of levelling the playing field in sports should be stopped may not, however, get much backing from the rules of the IAAF or the IOC.

Neither the IAAF regulations nor the IOC rules mention anything about surgery! They also do not talk of lowering testosterone levels through hormone therapy though that could be expected since otherwise an athlete found to have excess testosterone levels would not be able to come back into sports at all.

IAAF position on treatment

The IAAF rules (explanatory notes) do mention specifically that it would be entirely up to the athlete to undergo "treatment".
This is what is stated in the explanatory notes
"Will the IAAF be involved in carrying out medical diagnosis of an athlete and/or prescribing treatment?
"No. Diagnosis will always be carried out by medical experts at specialist reference centres that are independent of the IAAF and treatment, if any, will be prescribed by the athlete’s supervising physician. The IAAF will not be involved in either process. The IAAF’s role is strictly limited to deciding on the eligibility of such athletes to compete in its women’s competitions."

One is not sure what findings the medical panel reported to SAI about Dutee Chand’s condition. According to SAI's statement that announced the suspension of Dutee Chand  last July, it simply found out that the Odisha sprinter had a testosterone level higher than permitted by regulations.

Dutee's T level

The level of testosterone found out by the SAI in Dutee's sample, well above the IAAF ‘cut-off’, it was learnt, in itself might be of minor significance if Dutee and  her team are able to prove that testosterone was not a major factor in determining performance of a female athlete.

The question of biological sex could then come into the debate though that is something that both the IAAF and the IOC would not want to tread on.

Hopefully the details of her condition that alone had been kept out of the millions of words written over her these past few weeks, would remain within the medical records.

The IOC rules say that only men are eligible to participate in men’s competitions and only women are eligible to compete in women’s competitions.

The IOC rules 2014 also state “Human biology, however, allows for forms of intermediate levels between the conventional categories of male and female, sometimes referred to as intersex.Usually, intersex athletes can be placed in the male or female group on the basis of their legal sex. However, as explained below, intersex female athletes with elevated androgen production give rise to a particular concern in the context of competitive sports, which is referred to as “female hyperandrogenism.”

“In general, the performances of male and female athletes may differ mainly due to the fact that men produce significantly more androgenic hormones than women and, therefore, are under stronger influence of such hormones. Androgenic hormones have performance enhancing effects, particularly on strength, power and speed, which may provide a competitive advantage in sports. This is one of the reasons why the exogenous administration of such hormones and/or the promotion of the endogenous production of these hormones are banned under the World Anti-Doping Code, to which the IOC is a signatory.”

The task before CAS

Should  CAS allow women with any level of testosterone? Or should they uphold the rules and allow a ‘cut-off’ for T? Or should they determine a new level, slightly more than the current one since research seems to suggest that there could be higher levels among elite athletes? How high should it be pegged? Or will they suggest a more detailed investigating process before declaring an athlete ‘ineligible’?

Can the CAS arbiters rule a separate intersex category if that, and not hyperandrogenism alone, is the issue?

Or as someone commented in response to an article  can they“make it gender neutral”.

We will have to wait a few months since the initial CAS procedures do take time before the panel starts hearing the case.

Either way the verdict goes, this will be path-breaking.

(Concluded)

(amended on 31 Oct 2014)
Post-script-CAS has scheduled the Dutee Chand hearing for March 23-26, 2015.

Let CAS decide (Part I)

The topic of hyperandrogenism among female athletes, more pertinently the suspension of Odisha athlete Dutee Chand because of this condition, has sparked a vigorous debate in the international media and social forums. In this write-up, once again in two parts as was done in an earlier ‘hyperandrogenism’ piece on this blog, I have tried to explain what the issues are that seem to have caused great agitation across the world.

When I first wrote a piece on Dutee Chand in my blog last July, I was concerned about the issue of her ‘hyperandrogenism’ being openly debated in public. Little did I realize then that her ‘plight’ being publicized would actually help her in galvanizing support for a cause that could eventually pave the way for a ‘better deal’ for female athletes with hyperandrogenism.

As this piece on BBC Sport describes, the media focus has helped Dutee Chand attract world-wide attention and support that has brought an otherwise rarely debated issue to the fore.

Whether her failure to tick the ‘anonymity box’, as the BBC Sport piece suggests, was the reason why her case was allowed to be publicized or whether it was a mistake on the part of authorities might not be of relevance at this stage. What matters is the world of sports, nay the world beyond sports, is gripped with the ‘Dutee Chand issue’.
Unparalleled media focus
Dutee Chand’s hyperandrogenism issue has prompted a kind of response from the international media probably never before experienced for any similar cause in sports in India or elsewhere in the world.  The uproar caused by the ‘gender ban’ on South African 800m runner Caster Semenya in 2009 or the one before that on Indian middle distance runner Santhi Soundarajan pales in comparison.

From the BBC to the New York Times , from the Guardian and Sydney Morning Herald to Forbes and Al Jazeera and on a variety of websites, dealing with health, gender, science, sports etc, Dutee Chand has been featured beyond imagination during the past three months.

A Google search “Dutee Chand” will get you more than one lakh results in less than 0.25 seconds. A similar search for discus thrower Seema Antil, India’s lone individual gold medal -winning track and field athlete in the recent Asian Games in Incheon, will get you around 27,000 in around the same time.

This is not to suggest that Dutee’s case does not deserve the kind of attention that it has attracted. Far from it. Yet, something that should have been kept confidential has been splashed across the pages of the dailies and magazines with photos and we including this writer will continue to do so only because it has become such a furious debating issue.
Rules questioned
The plight of Dutee Chand has ignited a no-holds-barred debate across the globe in which critics are mostly ripping apart the hyperandrogenism rules of the International Association of Athletics Federations (IAAF) and the International Olympic Committee (IOC).

It is surprising the rules had not been questioned in this fashion since being introduced in 2011 (IAAF) and 2012 (IOC). Or for that matter the previous rules which were similar in essence without the 'hyperandrogenism' title or the testosterone cut-off limit. 

Perhaps the real import of the rules has been understood now only or perhaps the story of an 18-year-old Odisha sprinter, from a poor weavers family, and her dreams have provided a debating point that is hard to resist.

Of course as had been the norm through the past six decades when gender rules were brought in and enforced by the sports authorities in some form or the other, controversies and debates had been part of every such process. Whether you call this ‘hyperandrogenism’ rules or ‘gender rules’ these are evolving positions and rules that may yet change.
God-given advantage?

A legal intervention that has now been initiated by Dutee Chand, with support from the Sports Authority of India (SAI) and the Government of India, may bring about further changes. The world waits with bated breath the outcome of the Indian junior sprinter’s appeal before the Court of Arbitration for Sport (CAS), Lausanne.

The main argument in support of Dutee Chand relates to the natural occurrence of above-normal testosterone levels in some female athletes.

Peter Sonksen, professor of endocrinology (hormone studies) at St Thomas’ Hospital, London, told BBC Sport that his study on human growth hormone (hGH) found 16 % male athletes had lower than expected testosterone levels while 13 % female athletes had high levels of testosterone.

The Dutee Chand lobby has argued that anything that one is born with should not be considered as something that is denying the ‘level playing field’ to others or  being against the spirit of sport.

Her supporters have also argued that any attempt to medically ‘correct’ a particular testosterone level either through hormone therapy or surgery or both in order to become eligible would be unnecessary, discriminatory, unethical and against human rights.
'T factor not important'

There is also the suggestion that testosterone is not the single or the most important determinant in deciding performance, that never had a male masquerading as a female been ‘caught’ in the history of sports and that if there has to be controls related to androgens then it should be right across the board including for male competitors.

Those who have questioned this line of reasoning, mainly a few scientists, athletes and readers through comments to articles, have argued that male-female differentiation is necessary in sports since separate competitions are held for women and that testosterone, more than any other factor, should be considered as the most crucial in determining this differentiation.

The recent outcry against surgical intervention for female athletes found to have higher androgen levels (testosterone higher than the IAAF threshold of 10nmol/L or 288.18ng/dL) seems to be mainly based on a research paper published last year which stated that a study done on four unidentified athletes  in a French laboratory showed that 5 alpha-Reductase deficiency should be investigated in elite young female athletes with primary amenorrhea and high male T levels detected during anti-doping programmes to identify undiagnosed XY DSD (disorders of sex development).

Is this too much of scientific jargon?

Five-alpha Reductase deficiency (5-ARD) prevents the conversion of testosterone into the more active dihydrotestosterone (DHT) which is required for the masculinisation of external genitalia while the foetus is in uterus. 5-ARD eventually could lead to ambiguous genitalia.
A new study

The problem with the study, as far as critics are concerned, was not about the findings but the final procedures carried out on the four athletes.

To quote the paper**,”In contrast to the tendency to request gender change, our 4 athletes wished to maintain their female identity and had many questions about menstruation, sexual activity, and child-bearing. Although leaving male gonads in SDRD5A2 patients carries no health risk, each athlete was informed that gonadectomy would most likely decrease their performance level but allow them to continue elite sport in the female category. We thus proposed a partial clitoridectomy with a bilateral gonadectomy, followed by a deferred feminizing vaginoplasty and estrogen replacement therapy, to which the 4 athletes agreed after informed consent on surgical and medical procedures. Sports authorities then allowed them to continue competing in the female category 1 year after gonadectomy.”

Such a complicated process, perhaps endangering the health of the athletes, that too done in secrecy, without naming the authority that initiated the tests (after the London Olympics), has been considered as outrageous by many commentators.

(Testes produce the bulk of testosterone in males, with adrenal gland also providing a small percentage of it. In females, ovaries produce both estrogen, primary female hormone, and testosterone.  In intersex (hermaphrodite) individuals or conditions with ambiguous genitalia, a gonadectomy [removal of gonads or testes] is done in case it is desired to stop excess testosterone.)

We will come again to the ‘surgical requirement’ in hyperandrogenism cases later in this piece.

Dutee Chand shot into fame at the World Youth Athletics Championships in Donetsk, Ukraine, in 2013, making the 100m final, clocking on the way a PB of 11.62s in the heats, which still stands as the National Junior record.

In the Asian Junior Championships in Chinese Taipei earlier this year, Dutee won the 200m in another National Junior record time (23.57) and had a hand in the gold medal winning 4x400m relay team.

(A bungling in visa applications and resultant rescheduling of travel led to the team landing late at the venue ruling out Dutee for the 100m on the opening day.)

She was scheduled to participate in the World Junior Championships in Eugene, USA, last July, and, if possible, the Commonwealth Games in Glasgow as a reserve in the 4x100m relay team, when controversy erupted and she was sidelined.

The story from then on, mainly told through the foreign media and ‘experts’ on hyperandrogenism, gender etc is one of a talented junior sprinter being denied by a set of “cruel rules”.
SAI springs a surprise

That the Sports Authority of India (SAI) which conducted the tests on her at Bangalore, with some laboratory investigations done in Delhi, decided to challenge the IAAF rules in the Court of Arbitration for Sports (CAS) came as a surprise.

This is the first time SAI_and because of SAI the Government of India_has ventured into a territory like this. This is also the first time anyone has challenged the IOC/IAAF rules legally. Since this has world-wide ramifications, some of the leading figures in the fight against the ‘gender rules’ of the IAAF have joined hands with SAI to fight the case.

Interestingly, SAI which in pursuance of the Government-issued SOP conducted the investigations and declared Dutee 'ineligible' to compete in the female category would be funding the case with support from several others. The IAAF and the Athletics Federation of India (AFI) have been named as respondents by Dutee.

(to be continued)

**Molecular Diagnosis of 5α-Reductase Deficiency in 4 Elite Young Female Athletes Through Hormonal Screening for Hyperandrogenism Patrick Fénichel, Françoise Paris, Pascal Philibert, Sylvie Hiéronimus, Laura Gaspari, Jean-Yves Kurzenne, Patrick Chevallier, Stéphane Bermon, Nicolas Chevalier, and Charles Sultan

(amended Dec 3, 2014)

What do WADA statistics reveal? (part II)

Weightlifting, athletics lead

Olympic sports contributed 1.94 per cent ‘positive’ of 1,76,502 samples tested, at a total findings tally of 3426, out of which 1710 were ‘positive’. The balance 1716 produced atypical findings. Non-Olympic sports contributed 830 ‘positive’ results which came to 2.68 per cent and 322 ATF, coming to another 1.04 per cent for a total finding of 1,152 that came to 3.71 per cent.

Among major Olympic sport, weightlifting topped the charts with 3.4 per cent of positive results from 8553 samples tested.  ‘In competition’ there were 189 positive tests in weightlifting and out of competition (OOC) there were 98. Atypical results were 22 and 27 respectively.

Athletics (24,942 samples) and cycling (22,252 samples) came up with 1.2 per cent ‘positive’ reporting. Athletics had 180 AAF ‘in-competition’ and 63 AAF in OOC. There were 85 each atypical findings ‘in-competition’ as well as out of competition.

Despite all the adverse publicity received for cycling following the Lance Armstrong doping scandal and the suspicions around road cycling, the sport escaped occupying the No. 1 spot among frontline Olympic disciplines where large numbers of tests are carried out every year.

Cycling as a discipline, excluding road cycling, mountain biking etc, provided only 122 positive results from 5566 ‘in competition’ samples while road cycling (which includes events like the Tour de France) had 73 AAF from 4903 ‘in competition’ samples. Out of competition, cycling had 10 ‘positives’ reports while road cycling had 11.

NDTL scores high percentage

Among the 33 accredited laboratories the National Dope Testing Laboratory (NDTL), New Delhi, comes second for the percentage of ‘positives’ for the year 2013 (2.49%), behind Mexico City (8.27%) which happened to have been accredited only in June 2013 and tested only 1305 urine samples compared to NDTL’s 6489.

(NDTL’s own figures vary a little from the above, with 6885 samples for 2013 being published on its website for a percentage of 2.6 for ‘positives’. For 2014, up to July, it has tested 5026 samples for a ‘positives’ percentage, again, of 2.6)

It may be noted here that laboratories test samples from the countries that they are situated in as well as from other countries. NDTL, for example, tested 2458 ‘international samples’ in 2013 and has already done 2026 such samples up to July this year.

Among the IRMS (isotope ratio mass spectrometry) and EPO tests done by the laboratories in 2013, NDTL scored high with 77.8 per cent of ‘positives’, though from a very low number of samples. Of the 16 ‘in- competition’ samples under this category, 12 turned in ‘positives’ and of the two OOC samples both came ‘positive’.

IRMS is utilized to clinch evidence of exogenous administration of an endogenous androgen in order to exclude the argument from an athlete, “Of course, my body always produced this level of testosterone”.

IRMS determines exogenous administration of a steroid as it did in the Floyd Landis case. The American who came first in the 2006 Tour de France was disqualified for a doping offence involving T/E ratio and in a drawn-out case the decision was eventually upheld.

Among the labs that handled large volumes during the year,  Moscow tested 18609 urine samples, with 295 turning up ‘positive’ for a percentage of 1.56, Cologne did 16833 samples with 344 ‘positive’ tests making it 1.95 per cent, Beijing 15,319 samples with 46 ‘positive’ tests for a percentage of 0.30, Paris 9082 samples with 87 ‘positive’ for 0.91 per cent, Dresden 9032 samples with 36 ‘positives’ making it 0.39 per cent and Tokyo 7117 with 16 ‘positive’ results accounting for 0.22 per cent.

As in the previous years, anabolic agents (eg. steroids) headed the substances list with 3320 findings, accounting for 63 per cent of a total of 5271 cases reported in the ADAMS (anti-doping administration and management system) compared to 2279 and 50.6 per cent in 2012.

Stimulants came next at 530 cases and 10 per cent followed by diuretics and other masking agents at  393 (7.5%), glucocorticosteroids at 330 (6.3%), peptide hormones, growth factors and related substances at 202 (3.8%) and cannabinoids (e.g. cannabis, hashish, marijuana) at 188 (3.6%).

Among steroids, T/E ratio (testosterone-epitestosterone ratio to determine testosterone ‘positive’) topped with 1859, accounting for 59.6 per cent in the particular class of banned substances, followed by stanozolol (yes, according to some, the old-fashioned steroid made famous by Canadian sprinter Ben Johnson) at 329 (10.6%), dehdrocholomethyl-testosterone at 217 (7.0%), 19-norandrosterone (nandrolone metabolite) at 183 (5.9%), methandienone at 120 (3.8%) and boldenone at 77 (2.5%).

Not so old-fashioned!

Those who still believe, especially in India, despite yearly statistics revealing otherwise, that Indians use “outdated” drugs when reports come in of testosterone, stanozolol or methandienone being ‘choice drugs’ among Indian sportspersons, especially track and field athletes, could be encouraged to believe that these remain on top of the list world-wide also.

It is of course easy to talk of “designer drugs” since no one knows what they are or whether you have an athlete who has that in his/her body till a Don Catlin discovers one, formulates a test, reports it and it is approved for use by accredited laboratories.

Among stimulants, methylhexaneamine (MHA)_you guessed it right_ that made big headlines in India in 2010 and 11 cases  related to it dragged on for years, topped with 169 ‘positives’ accounting for 31.9 per cent within the class of substances. It was down on the 2012 figure of 320 that came up to 45.9 per cent within the drug class.

Methylphenidate, used in attention deficit disorders, and narcolepsy, came to 66 cases and 12.5 per cent among stimulants followed by cocaine at 52 ‘positive’ accounting for 9.8 per cent.

Among the International Federations, International Cycling Union (UCI) was in the forefront, with 6096 ‘in-competition’ samples and 2967 OOC samples accounting for 9430 samples and an adverse analytical finding of 1.0 per cent.

The International Association of Athletics Federations (IAAF) followed with 4376 tests including 1859 OOC, also with a one per cent ‘positive’ report.

The International Tennis Federation (ITF), with 2578 tests and 0.5 per cent adverse findings and the International Weightlifting Federation (IWF) with 1937 tests and 5.3 per cent adverse findings were the other leading international federations in the fight against doping last year.

Just one adverse finding in cricket

Of interest to the Indian fans, the International Cricket Council (ICC) conducted 122 ‘in-competition’ tests, with two atypical findings and one adverse analytical finding, and 266 OOC samples with zero adverse findings. In all, ICC tests reported 0.3 per cent adverse findings.

Among National Anti Doping Organisations (NADOs), Russia led the way with 6949 tests ‘in-competition’ and 7463 OOC tests, for a total of 14582 tests that returned 199 adverse findings, accounting for 1.4 per cent.

China (13364 samples and 0.2 per cent adverse findings), Germany (7709 and 0.2 per cent) and USA (7144 and 0.9 per cent) were the other leading NADOs in terms of number of tests done during the year.

India (NADA) did 4848 tests that came up with 93 adverse findings (also a negligible two cases of atypical findings, one each ‘in-competition and OOC) for a percentage of 2.2.

There were some abnormal figures resulting from limited number of tests that turned up higher than expected ‘positive’ results. El Salvador did just three tests and found two of them had come ‘positive’ accounting for 66.7 per cent!

Other countries that reported higher percentage for adverse findings from a limited number of samples included Ukraine (11.1%), Kuwait (10.6%), Mexico (10.4%), Niger (10.0%), Belarus (8.2%) and Iran (7.7%).

(concluded)

Out-of-competition testing holds the key

What do WADA statistics reveal? (part I)

The World Anti-Doping Agency (WADA) has published testing statistics for the year 2013. And as usual these are quite revealing, not just in terms of the increase or decrease in numbers and percentages compared to the previous year but also in respect of the areas of neglect among various agencies.

Quite pertinently, in the Indian context, the inability of the National Anti Doping Agency (NADA) in coming to grips with its “whereabouts” programme is reflected in the testing figures published last July.

From a total of 1494 out-of-competition tests (OOCT) done by the NADA, there were only five ‘positive’ results, representing just 0.33 per cent in an overall 2.2 per cent of ‘positives’ for all tests put together. This included 88 adverse analytical findings (AAF) from 2579 ‘in-competition’ tests that NADA conducted across all sports during the year.

Russian testing figures

In comparison, Russia, which, like India had been in the news for all the wrong reasons in athletics of late, being the No. 1 country in the doping list of the IAAF, had 42 ‘positive’ cases from 7463 OOCT. Or for that matter, the UK, which did 1688 OOCT had 10 ‘positive’ results.

Russia had 157 ‘positive’ reports from 6949 ‘in-competition’ tests for an overall percentage of 1.4 from a total of 14,582 tests. The UKAD had 17 AAF from 2349 ‘in-competition’ tests for an overall 0.6 per cent ‘positive’

This is not to suggest that an agency will always have a bigger ‘catch’ from an OOCT regimen. But in theory at least that is the truth. Athletes come into competition knowing well that there is a chance they would be tested. Because of that they try to enter a competition “clean”, meaning they get rid of the traces of the drugs that they might have been taking without losing all the benefits of such substances. It is only because of some miscalculation that a few of them get caught during competitions, or, in rare cases nowadays because of the more sophisticated testing methods and equipment that the laboratories employ.

Quite often you hear the question from unsuspecting followers of sports,“but they were tested in the games, isn’t it? Then how can anyone say that they might have been on dope?”

The doping game

They would not come into the event doped and in a condition where they know their urine sample would turn up a ‘positive’ result. The whole doping game is dependent on consuming the drug, not getting tested for a period when you don’t want to be tested, tapering off and then coming into competition “clean”. At the same time you make sure all the benefits that you seemed to have derived during your doping exercise is not completely drained out which then will make the whole programme useless.

Latest research, yet to be applied to humans, has established that athletes could derive the benefits of steroids for decades, possibly life-long.

Out-of-competition testing, especially based on a “whereabouts” programme takes the athlete by surprise. If an agency can keep track of an athlete at his place of residence or training base, chances are he may not take the risk of doping knowing well the testers might pounce on him any time.

In the Indian context where NADA’s basic OOCT centres around testing at the NIS, Patiala, and the South Centre, SAI, Bangalore, it is imperative that the NADA gets its “whereabouts” act in place. For, testing missions at such centres invariably leak out and targeted athletes are able to evade the testers easily.

If a ‘whereabouts” is in place, there will be no question of evasion because three ‘missed tests’ in an 18-month period would mean a violation of rules that could attract a two-year ban under current rules.
Under 'whereabouts" an athlete, at the national level, is expected to provide his/her whereabouts on a quarterly basis and is expected to be available at a particular place, as indicated by the athlete, for sample collection at least for one hour during a designated period between 6 a.m and 11 p.m every day of the year. The tester could be expected to wait for one hour in case the athlete is missing and then would be free to mark a 'missed test'. The 'whereabouts' information could be updated from time to time in case of unforeseen circumstances that may force the athlete to miss appointment at the designated place.

The 'whereabouts' routine to be enforced by NADA in athletics was supposed to have come into operation shortly after the Commonwealth Games in Glasgow, but there are no indications yet that this has happened. Even if the list is ready in all sports where NADA wants to begin registered testing pools and testing based on ‘whereabouts’, including athletics, where there had been a delay for more than a year, it is not known whether the testing has begun. In any case, NADA is yet to publish the criteria for finalization of such registered pools in different sports.

Thirty-three WADA accredited laboratories tested  2,69,878 samples last year to return 3,529 AAFs and 2433 atypical findings (ATFs) for a total of 5,962 findings and an overall percentage of 2.21. (Atypical findings are those where certain endogenous substances or other threshold substances may come up at a higher level and are reported as ATF for the testing authority to pursue those cases, all of which may not eventually be charged as a ‘positive’ result.)

Though the AAF percentage of 0.97 (1710) for Olympic sports in 2013 was lower than the previous year (1831 and 0.99 per cent), the total findings at 2.21 per cent was much higher than the 1.76 per cent recorded for 2012.

 (to be continued)

(updated on 15 Oct, 2014)