EPO makes its Indian debut

Fifteen years after the International Olympic Committee (IOC) introduced a test for the detection of erythropoietin (EPO) India has opened its account for an anti-doping rule violation for the red-blood-cell boosting drug.

Distance runner Hari Shankar Sharma, who tested positive for EPO at the All-India Police athletics championships at Madhuban, Haryana, in November last year, has been suspended for two years by the National Anti-Doping Disciplinary Panel (NADDP).

That this case, dating back to 28 November, 2014 could be decided only on 5 November, 2015 was due to a combination of reasons.

The New Delhi Dope Testing Laboratory (NDTL), a WADA-accredited laboratory, is shown to have tested the ‘A’ urine sample on 10 March, 2015. But apparently confirmatory evaluation was by then done by another WADA-accredited laboratory in Seibersdorf, Austria and that explained the first delay. The Austrian laboratory is the Athlete Passport Management Unit (APMU) for tests done by the National Anti-Doping Agency (NADA).

Delays

By the time the ‘B’ sample test was done and presence of EPO confirmed it was May. There was a further time lag since the hearing panels had ended their term in February this year and were not reconstituted by the Government till July.  Actually the old panels were re-nominated then and a further reconstitution done only last month. Sharma’s case got delayed in the backlog and was taken up on 20 October.

Sharma did not put up a credible defence, going by the order issued by a panel headed by Mr. Ramnath and including international shooter Moraad Ali Khan and DrL. K. Gupta. The Rajasthan runner who took the gold in the 10,000 metres (30:07.48, ranked 7th in India in 2014) and the silver in the 5000 metres (14:35.38, ranked 12th) at Madhuban, argued that he had undergone treatment for an elbow injury in 2014 and was prescribed some medicines. There was no prescription to back up that claim. He also said he had consumed calcium and vitamin tablets.

Sharma was lucky that his case came under the old Code (2009) and not 2015 since the minimum sanction under the new rules would have been for four years unless unintentional ingestion was established.

What is EPO?

EPO is a hormone produced by the kidneys. An increase in EPO will mean extra red blood cells which in turn will mean supply of more oxygen to the muscles. Artificially it is prepared through recombinant DNA technology. It is used to treat anaemia in the medical field but it also happens to be favourite among endurance athletes for doping purposes. The Tour de France has been notorious for EPO misuse. American Lance Armstrong, stripped of his seven Tour de France titles for doping and banned for life, admitted that he had benefited from the use of EPO.

Just as Armstrong pointed out in the documentary the ‘Armstrong Lie’, EPO detection is difficult since its half life (period during which it could be detected in blood) is around four to five hours. Initially the IOC accepted a method of blood test and urine test to confirm EPO ‘positive’ just in time for the Sydney Olympics. Not many were caught in the initial years.

Subsequently, as science and detection methods evolved, the World Anti Doping Agency (WADA) was able to approve a stand-alone urine test, though it is costly to conduct. Many anti-doping agencies including international federations even now use a combination of blood and urine tests; many use blood tests for screening purposes.

By 2008 the dopers were onto CERA (Continuous Erythropoiesis Receptor Activator), a new form of EPO that was used to help dialysis patients or people with kidney problems.

Biological Passport

Since 2009, WADA has introduced the Athlete Biological Passport (ABP) programme by which an athlete’s blood sample is tested and variables recorded during different stages in order to assess misuse of erythropoiesis stimulating agents (ESA). Suspect cases are followed up for target testing or else brought up as an anti-doping rule violation charge if sufficient evidence is gathered.

The recent uproar over ‘leaked data’ published by German TV ADR in collaboration with the Sunday Times of U. K. related to EPO misuse and blood doping by elite athletes including medal winners in Olympics and World Championships from several countries, Russia topping that list.

The International Association of Athletics Federations (IAAF) is still looking into that issue while a second report by WADA Independent Commission that could be expected to deal with the blood doping allegation among others could be out by December-January.

Recent studies have shown that micro-dosing in EPO is extremely difficult to catch. Athletes can continue to dope and not get detected through micro-dosing, a BBC journalist proved 

The NADA is yet to begin haematological ABP programme though blood samples from India are taken and international agencies could be expected to keep a watch on the data generated over a period of time in order to carry out target testing at least.

NADA has however started steroidal ABP (urine sample) by which an athlete’s steroidal pattern is kept track of. WADA started the ABP (blood) programme in 2009 and the steroidal module in January 2014.

EPO is costly. Its testing is costlier than routine testing of urine samples, making agencies do tests only on a very limited number of samples for the drug. EPO is available in the Indian market. How athletes, cyclists etc could be misusing it in India could be assessed better once the ABP programme is set in motion.

Quite interestingly, a second EPO ‘positive’ reported in India in 2014 also came from the Police championships at Madhuban. It is another distance runner who ran alongside Sharma. His case is expected to be completed soon.

Just because only two athletes have been caught so far in India for EPO should not mean others were not using it. The detection window being small the others might have been lucky to escape.  We should also remember that NADA came into being only in 2009 and the New Delhi laboratory was accredited less than a year earlier. The ‘passport’ as and when introduced should nail many EPO users in future.

Meanwhile, K. M. Rachna, hammer thrower from UP, who stood second in the National Games in Kerala last February, has been suspended for four years by the NADDP. She was one of the 16 to have tested positive at the games. Rachna had tested positive for steroid metenolone.  
(amended 27 Nov 2015)

National Federations' apathy (Part II)

(Click here for Part I)

Gazette notifications 

Before the hearing panels were re-nominated last July, NADA had imposed its authority for six years on the NSFs and their athletes largely on the strength of a gazette notification dated January 6, 2009.

One more gazette notification was issued on June 2, 2015, notifying the revised NADA anti-doping rules based on the 2015 WADA Code.

Quite pertinently, the gazette notification, in 2009 as well as in 2015, says the same things that the rules also stipulate. That is as per the gazette notification “As a condition of receiving financial and/or other assistance from the Government of India and/or the National Olympic Committee of India, each National Federation of India shall accept and abide by the spirit and terms of India’s National Anti-Doping Program and these Anti-Doping Rules, and shall incorporate these Anti-Doping Rules either directly or by reference into their governing documents, constitution and/or rules…”

The notification is not saying that once the rules are published in the Gazette of India, it would be construed that the federations have already incorporated these rules into their constitutions/governing documents/rules.

A gazette notification precludes the need to further publicize or inform the public or concerned authorities about the subject of the notification. It need not fufil the requirements to be met by the authorities as detailed in the notification. Simple logic says that. There could of course be a legalistic or bureaucratic interpretation to this which the legal fraternity or the bureaucracy can look into.

Debate over enforcement of new rules

The enforcement of the 2015 NADA anti-doping rules to cases that came up before the gazette notification in June including 16 from the National Games in February this year was under a cloud at one stage, with the disciplinary panel raising doubts about its validity without having either “notified” (gazetted) or circulated among all stakeholders well in advance.

The objections were eventually overcome by NADA which now has again revamped the hearing panels with the induction of a new set of chairpersons to head the two panels and a few other members including hockey Olympian and World Cup-winning captain Ajitpal Singh and trap shooter Moraad Ali Khan.

It is difficult to imagine that six years have gone by and the NSFs (barring Hockey India perhaps and any other which might have escaped one’s attention) have either retained irrelevant anti-doping rules or provided meaningless background and/or links or just met the requirement mentioned in the Sports Ministry circular last March, among 23 points, that they provide a note on their websites about ‘compliance to WADA/NADA Code”.

Examples of Federation websites

A few examples of information available on the websites are mentioned here and you will readily grasp the cavalier manner in which this topic has been dealt with by many of the NSFs.

The Swimming Federation of India (SFI) does not have anti-doping rules but does have links to FINA and Swimming World magazine!

The Wrestling Federation of India (WFI) constitution is silent on anti-doping rules but the website does provide links to WADA and NADA.

The All India Tennis Association (AITA) does not have a mention of anti-doping rules while the Badminton Association of India (BAI) has an anti-doping section minus any reference to NADA. It has links to WADA and Badminton World Federation anti-doping rules.

Football (AIFF) and Table Tennis (TTFI) also do not have any reference to anti-doping on their websites.

Cycling (CFI) and shooting (NRAI) have complied with the ministry notification of March 2015 by giving a small note about how they follow NADA rules and the names of those who had tested positive.

The Indian Kayaking and Canoeing Association has a page devoted to ‘anti-doping’. But one would be quickly disappointed. It has background on WADA, Council of Europe Anti-Doping Convention and the UNESCO Convention against Doping in Sports. But nothing on NADA rules, no link to WADA Code or Prohibited List.

Definition of NADO!

Kabaddi (AKFI) gives the definition of a National Anti Doping Organization (NADO). Within that one can learn that a NADO does have certain authority, if you were unaware of such an authority.

The Judo Federation provides a note about having held a seminar. Perhaps it understood the ministry’s circular meant just that only. It also lists two suspended athletes.

The Equestrian Federation constitution, as available on its website, does not mention anti-doping. The Squash Rackets Federation of India (SRFI) on the other hand provides links to NADA rules 2015,WADA Code, WSF anti-doping rules, WSF jurisdiction, WADA education and awareness, 2015 Prohibited List and the MYAS compliance list. Yet it does not state that NADA rules would be the rules by which SRFI and squash players would be governed.

Let us take a look at some of the National Federations in other countries and at least try to understand what is needed:

Tennis Australia

“Under this Anti-Doping Policy, TA recognises the authority and responsibility of Australian Sports Anti Doping Authority ASADA under this Anti-Doping Policy and the ASADA Act and ASADA Regulations (including carrying out Testing). TA shall also recognise, abide by and give effect to the decisions made pursuant to this Anti-Doping Policy, including the decisions of hearing panels imposing sanctions on Individuals under their jurisdiction.”

UK Athletics

“In accordance with Rule 5.1 of these Rules, UKA has appointed UK Anti-Doping ("UKAD") to carry out the Testing of Athletes and the results management process. A copy of the Notice confirming UKAD's appointment was first published on the UKA website on 14 December 2009 and is reproduced in Schedule 3 of these Rules. The Notice remains in force.”

USA Swimming

“Doping control-In-Competition Testing: All competing athletes at USA Swimming competitions are subject to drug testing conducted by the United States Anti-Doping Agency (USADA) and FINA under the In-Competition Testing program. 

“While all USA Swimming athletes are eligible to be tested out of competition, athletes in the Registered Testing Pool will be tested regularly and at any time between the hours of  5 am and 11pm daily. Athletes may be tested by USADA, FINA and WADA.”
 British Weightlifting

“The anti-doping rules of British Weight Lifting are the UK Anti-Doping Rules published by UK Anti Doping (or its successor), as amended from time to time. Such rules shall take effect and be construed as the rules of British Weight Lifting.”

NADA has to pursue

NADA has done a good job during its six years of existence by trapping more than 570 athletes who were found to have violated anti-doping rules. We can always argue that doping is so rampant in India that the numbers were bound to be high. But then someone has to not only catch them but also get sanctions imposed on them.

With a set-up that is clearly understaffed NADA needs to get tough with the NSFs, with adequate backing from the Sports Ministry, to get the rules business sorted out for its own good. The Ministry could be expected to clearly define what is needed to be put up on the NSFs’ websites in terms of anti-doping rules, education and awareness programme, rights of athletes, warnings about use of dietary supplements, and useful links to rules and news.

Just by asking them to put up a note this is what the ministry will get (a representative sample from AIFF website):

“Regular samples are collected during various I-League and other major tournaments under the supervision of NADA officials. One case has been tested positively. Name: Dane Pereira,Club: Mumbai FC. Test conducted on: 23^rd Feb 2015 at Mumbai.”

This information is something the ministry can  easily get from NADA office. More importantly this is of no great use to the players, coaches, public or the media. The players/athletes, especially the younger ones, need to be educated about the ramifications of doping, the health issues, the anti-doping rules, NADA’s authority, consequences of doping, “strict liability principle” that is applied when someone tests positive, the process of sample collection, rights of an athlete, the hearing process, right of appeal, latest news about prohibited substances and the need to be vigilant about consumption of dietary supplements, among other things.

At a time when UNESCO is calling for more efforts to educate the athletes about the dangers of doping, we seem to lag well behind in taking simple initiatives.

(concluded)
NOTE: Since publishing, some federations have updated their websites and rules. Here is the IWLF anti-doping policy:

http://www.iwlf.in/pdf/anti-doping-policy-of-iwlf-effective-december2016.pdf

National Federations' apathy (part I)

Hockey India an exception in adopting unambiguous anti-doping rules

What authority does the National Anti Doping Authority (NADA) have to collect urine and blood samples from athletes, get them tested, bring forward rule violations before a disciplinary panel and impose sanctions as ordered by the panel?

In a large majority of Indian sports, especially Olympic sports, there apparently is no clear-cut authority if you go by the present arrangement. Unless you agree that a gazette notification does over-ride all provisions within the anti-doping Code that stipulate a set of rules to be incorporated by the federations in their rules to provide NADA this responsibility and authority.

During the past two years one has spent time over the websites of the National Sports Federations (NSFs) trying to find whether any of them had incorporated the rules that provide NADA the authority to be the sole anti-doping agency in India to collect samples and carry out ‘results management’.

On a re-check of several websites on Sunday (Nov 1) after more than a year’s gap, I found one! Hockey India (HI) has a document titled ‘Hockey India Anti Doping Policy and Regulations’.  It contains the provisions that provide NADA the authority to test hockey players in India and to bring forward disciplinary procedures.

“By accepting the NADA rules and regulations on doping control Hockey India has agreed to share/bestow the below-mentioned duties and responsibilities to NADA with regard to doping control in the discipline of Field and Indoor hockey”, says the HI anti-doping policy.

The rules are effective from January 1, 2015.

The points that follow this statement include all testing responsibilities, ‘results management’ procedures and right of granting of Therapeutic Use Exemption (TUE) being delegated to NADA among other things.

HI might have done better had it also mentioned NADA’s authority in its constitution, though it was not mandatory. But when a reference to the WADA Code is there in the constitution, a mention about the NADA rules might have been just the right thing to do.

But well done Hockey India! You have left no room for ambiguity.

'Deemed acceptance'

Do we actually require an NSF to incorporate any NADA rule or grant NADA any authority when the NADA anti-doping rules have been gazetted?

Here the opinion differs. Some lawyers and officials with whom I had interacted during the 2009-2013 period when everyone was coming to grips with the changed set-up of anti-doping in India, felt that the gazette notification would be sufficient. A few others were not so sure.

The federations were deemed to have accepted the rules since they did not object to them even after publication of the rules in the gazette and notification of the same in newspapers. Can 'deemed acceptance' be a substitute for "incorporation of rules" into constitutions/governing documents"?

Will the ‘so-called’ authority derived from a gazette notification hold good in a court of law or the Court of Arbitration for Sport (CAS)?

Since it has not been challenged, no one could tell for sure. But one point that one of the legal brains made was the fact that an athlete was presumed to have agreed to subject himself/herself to the procedures including disciplinary hearings without raising an objection and that might preclude any challenge at a later stage.

One was not sure about this argument and left it at that. Yet, a few questions could remain on this score also. Do the athletes come into these proceedings agreeing in writing to the authority of NADA and the hearing panels? Do they know the authority of NADA when they are tested?

Poor response from NSFs

No one seems to have questioned the authority of NADA or that of the panels so far. Nor would it look that the NADA has been trying to get this aspect sorted out with the federations all these years. Yes, it did attempt in 2008-2009 when it brought in these rules and wrote to the federations. Not many bothered to reply even, forget about incorporating these rules into their constitutions.

If one could recall correctly, the Athletics Federation of India (AFI) wrote back that NADA could carry out out-of-competition testing while the federation would conduct ‘in-competition’ testing. The argument was not pressed once NADA got into the act though the AFI did play a major role during ‘in-competition’ test distribution plan at least in those early years.

Another federation to respond was the Basketball Federation of India which stated that it would be willing to convene a special general meeting, if required, to amend its constitution appropriately to include the provision to bring in NADA rules.  Unfortunately, it seems, such promises were never followed up.

If one checks up the websites of the federations, some of them do have a mention of ‘NADA’ in some document or the other or on some page or the other, but rarely has one come across a constitution of a federation or rules that incorporate the complete NADA rules “either directly or by reference” as has been done by Hockey India.

The Indian Weightlifting Federation (IWLF) used to have separate rules applicable for sanctions in respect of ‘national-level’ and ‘international-level’ weightlifters in doping cases. The IWLF website currently does not provide a clue about its ‘anti-doping policy’ though it is a topic within the contents of its home page. There are no details available.

The AFI website does have a mention of ‘anti-doping’, though tucked away within, strangely, something called ‘development programme’, as had been mentioned  in these columns previously too.

Confusing rules

The AFI website section on doping primarily provides the composition of its Medical Commission, its role, functions etc.

A headline “In consonance with WADA Anti-Doping Rules” may suggest the adoption of WADA Code or NADA rules, but there is no further reference to such things under that headline.  It of course says the rules are in consonance with the IAAF anti-doping rules. And there was a need to incorporate these rules into “our constitution”.

The AFI constitution, as amended in 2013, still refers to the old IAAF and AFI rules; there is no mention of NADA here.

Rule 4 says “The AFI will be responsible for doping control at i) national championships, ii) regional championships (All AFI affiliated/recognized units meets), iii) University & School Games , iv) on other occasions when random and or designated testing is carried out, for example Area Group Championships or meetings. At these meetings an AFI or area representative shall be present

Rule 5 says 3) every athlete shall have the right to a hearing before the relevant tribunal of AFI before any decision on eligibility is reached.

The NADA rules

What do NADA rules, based on the WADA Code, say?

“1.2.1 As a condition of receiving financial and/or other assistance from the Government of India and/or the National Olympic Committee of India, each National Federation of India shall accept and abide by the spirit and terms of India’s National Anti-Doping Program and these Anti-Doping Rules, and shall

incorporate these Anti-Doping Rules either directly or by reference into their governing documents, constitution and/or rules as part of the rules of sport that bind their members and Participants.” So says the NADA anti-doping rules 2015.

There has been no change in these provisions from the 2009 version. And no changes in the following provision also:

“1.2.2 By adopting these Anti-Doping Rules, and incorporating them into their governing documents and rules of sport, National Federations recognize the authority and responsibility of NADA for implementing the National Anti-Doping Program and enforcing these Anti-Doping Rules (including carrying out Testing) in respect of all of the Persons listed in Article 1.3 below who are under the jurisdiction of the National Federation, and shall cooperate with and support NADA in that function. They shall also recognize, abide by and give effect to the decisions made pursuant to these Anti-Doping Rules, including the decisions of hearing panels imposing sanctions on individuals under their jurisdiction.”

It goes without saying NADA has to have some authority to test athletes, carry out ‘results management’ procedures, bring forward cases for hearing and impose sanctions following such procedures. That authority has to be delegated by the National Federations.

(Continued in Part II)