For Anti-Doping Administrators, a Constant Battle Requiring Creativity & Strong Leadership

Note: For more on Professor Ljungqvist’s fight against doping in Sweden, and its effect on Scandinavian sport culture, you can read our companion piece, also published this morning.

STOCKHOLM, Sweden – Professor Arne Ljungvist has been fighting doping since the 1970’s, when he began with the Swedish Athletics Association and the International Association of Athletics Federations (IAAF). These days, he has retired from his day job – researching cancer and other medical topics at the prestigious Karolinska Institute – and holds two others: the head of the International Olympic Committee (IOC) Medical Commission, and the vice presidency of the World Antidoping Agency (WADA).

In the intervening decades, doping rose to seemingly absurd levels, but Ljungqvist believes that in some sports, performance-enhancing drugs are no longer so prevalent.

“You can see it,” he told FasterSkier. “In measurable sport, you can see the difference. In no [Olympic] throwing event in London would the gold medalist been on the podium in Seoul 24 years ago. It’s incredible. So it’s been cleaned up.”

But that doesn’t mean that the problem is gone – it is an ever-evolving, ever-escalating battle between dopers and administrators. In some ways, the efforts by people like Ljungqvist are still the same as they were in the 1960’s, when one of the biggest jobs was simply determining which substances ought to be banned. Administrators have always been trying to catch up with dopers, tests always lagging behind the discovery of new performance-enhancing substances and methods.

And as they have lost patience, perhaps, the game has changed. Recognizing that they won’t be able to test every athlete for every possible performance-enhancing method at every potentially important time, administrators have in recent years embraced “non-analytical” cases where there is no positive test for a banned substance. This tool for catching cheaters was showcased last month when Lance Armstrong was stripped of his seven Tour de France titles, based mostly on the words of other cyclists.

With these changes and challenges in mind, FasterSkier asked Ljungqvist and Staffan Sahlström, a longtime ally of the professor’s, a few questions about sports today in a long interview at the offices of International Doping Tests and Management (IDTM), a company which Sahlström founded here in Stockholm.

No-Start Rules and Biological Passports

The International Ski Federation (FIS) was one of the first federations to try to nail dopers without an actual positive test. One of the main goals of endurance athletes who dope is to raise the capacity of their blood to carry oxygen. For a long time, there was no test for erythropoietin (EPO), the main drug used to do so. Then, too, dopers learned to reinject their own blood back into their veins, which was hard to detect. So the federation got creative.

“FIS felt that they had problems with blood doping, and the Finnish incident proved that they were right,” Ljungqvist said, referring to the scandal that disqualified six Finns from FIS World Championships in 2001. “And the way they tried to stop it in the absence of detection was to institute this no-start rule, to say that if you had too-high blood counts you couldn’t compete because it would be dangerous to your health.”

The rule, which stated that no skier could start a race if their hemoglobin tested higher than 16.5 g/dl for women or 18.5 g/dl for men, was designed to detect the symptoms of blood doping, if not the actual substances or transfused blood itself. To the public, FIS explained that having too-thick blood was dangerous, which was true, but not the real purpose of the rule.

The rule did work, if its goal was to lower competitors’ hemoglobin levels before they raced. In 2006, U.S. skiers Leif Zimmerman and Kikkan Randall had to wait five days before re-testing and competing in the Torino Games. At the 2010 Olympics, Maine-based New Zealand racer Ben Koons encountered the same problem.

According to Ljungqvist and many others – such as the aforementioned three, who say their hemoglobin levels had nothing to do with doping – it wasn’t a good solution.

“I don’t like that,” he said of the FIS policy. “I think they were covering themselves under a false argument. And I told them that many times – that there is no proof, and particularly the individual, probably, some are born with different levels. This is a bad excuse. They were trying to combat doping with a false argument. That’s ethically doubtful.”

Not only is hemoglobin likely under some degree of genetic control, but it can also be affected by living at altitude (which can train the body to carry more oxygen in the blood) or even by dehydration. Plus, the rule didn’t actually catch all the cheaters. Ljungqvist pointed out that Armstrong, for instance, had repeatedly taken saline infusions to dilute his blood when he knew he would be tested.

“They notify the skiers by just putting up a message in the lockerroom, which says, you are due for your blood sampling at nine o’clock,” Sahlström explained to get at the rule’s shortcomings. “So you have a notification and even though you are observed during your notification, the bad guys could do something. And the levels are just below – a little bit too little below. So they achieved something, but it is a false excuse.”

FIS has expanded the concept, however, into something called an “athlete biological passport.” The idea is that by tracking markers like hemoglobin through time, administrators will have some idea of an athlete’s natural levels, and if they dope, the changes will show up in tests even if the substance itself does not. Last season, FIS administered 1,432 out-of-competition tests as part of its biological passport program.

“I think it’s well worth trying, and it’s a good idea,” Ljungqvist said of the passport concept. “We’ll see if it works. It has already been used – the International Cycling Union has been doing it, IAAF did it just before London, and they banned a few athletes based on passport information. The more sophisticated, the more detailed you can make the passport, the better.”

As part of his role with WADA, Ljungqvist has watched the agency adopt the program itself. Next week, he’ll take part in discussions about whether WADA can expand the passport to include endocrinology data, which could help detect steroid and hormone use – as well as other future methods that athletes haven’t even tried yet. For the first time, Ljungqvist hopes, maybe administrators will be one step ahead of dopers, rather than the other way around.

“Maybe we will finally have a good identification of the athlete’s biochemistry,” he said. “That will also be helpful when it comes to detecting gene doping, so it’s a good path to follow.”

Strong Leadership for Clean Sport

In the fallout from the Armstrong scandal, many clean athletes have to wonder: how do I know that the playing field is level, and that the system is working, if Lance Armstrong could get by for so long without being caught?

That, say Ljungqvist and Sahlström, depends on a lot of things, sport and country among them. But in the U.S., athletes shouldn’t be too worried, Ljungqvist believes. He remembers what happened at the Sydney Olympics in 2000, when it came out that U.S. athletes had tested positive for banned substances, but the cases had been swept under the rug by the U.S. Track and Field federation and the United States Olympic Committee (USOC). At the time, Ljungqvist publicly states that the Americans had failed to do their jobs.

“I got a direct call from the responsible people at the White House, the drug czar, who told me that they understood our problems in Sydney,” he said. “I had criticized them and it had come out in the United States newspapers. So they said, please, calm down, if you can, and we’ll do something. And they did. They created USADA.”

Recently, Ljungqvist says, USADA has done an admirable job tackling the rampant doping in Olympic sports (professional sports are, of course, another matter). He cited first the BALCO investigation, and then the Armstrong affair, as cases where the agency laid out meticulous cases against high-profile athletes and didn’t seem hampered by political pressure.

“They were very thorough, very serious, and very professional,” Ljungqvist said. “They are cleaning up sport in the United States. But it shows that the system had been bad… this goes back to the late 1990’s and early 2000’s. They weren’t doing the job. Marion Jones is another example – tested hundreds of times, at the wrong times.”

The turnaround was due to something that hasn’t happened in every country: the antidoping agency was separated from any organizations that might have an interest in the outcome, like the government or the national Olympic Committee. One reason that the U.S. system had been so bad, Ljungqvist implied, was that it had been enforced by two organizations which had a vested interest in U.S. athletes winning medals, and so had some incentive to avoid banning star performers.

“I think that one of the answers [to the doping problem] is the independence of the organizations that are handling different cases,” Sahlström said. “And then it should be discussed, what is being independent? I can question being independent in some countries.”

He would know, because IDTM handles doping tests for various federations around the world. The company started based on the pair’s out-of-competition testing program in Sweden; the IAAF asked, can you do this internationally? Since then, Sahlström  has assembled a network of doping control officers around the globe. And different countries, he says, sometimes have different ideas of what a doping agency should do.

Then there’s the question of who is leading national agencies and international federations. Travis Tygard of USADA has gotten a lot of press lately, as have International Cycling Union President and Vice President Pat McQuaid and Hein Verbruggen. While Tygard attacked a popular American hero, the UCI leaders quietly protected a system of doping in their sport. People have called for the resignation of all three, for various reasons: Armstrong reporters are furious at what Tygard has done, while fans of pure sport are disappointed in the spinelessness of the UCI.

“It’s difficult to be the governing body – you have to run the sport,” Sahlström admitted. “If you are not strong as Professor Ljungqvist has been in the IAAF, and if you have weak leadership that says, okay, we need to protect our athletes because they are our asset and they can’t be found doped and we will lose sponsorships, or TV rights, et cetera, then that’s something that we should be looking into.”

Whether it’s at the USOC, USSA, USADA, or FIS, athletes have to rely on their leaders – and that’s a big question. It’s made tougher, Sahlström said, because most of these high-level administrators keep their jobs for a long time – sometimes decades. The lines can blur after such long relationships, he suggested, and administrators can bow under the pressure from athletes and coaches to ignore problems with doping.

“If you have a fairly closed family like the professional cyclists, they all know each other,” Ljungqvist said. “Sports-wise, it’s a small group. It’s easy to organize something and people protect each other.”

In insular sports such as cycling, Sahlström agreed, it’s a tougher problem.

“For leaders to start to clean out something, it takes some courage, and I’m not sure that every leader today has that,” he said. “Who are the leaders? Are they strong enough? If there are leaders who have been part of an old regime, I’m not accusing anyone, but if you have been in that area, then no. If you come into a federation with new eyes and ears you can say, okay, something has to be done. But if you have been part of it, you would be biased.”

Should American skiers be worried, though? Of course no sport is perfect. But as Americans, the athletes should trust USADA, the pair said. And as skiers – well, at least it’s not cycling.

“The confidence in the system, I wouldn’t doubt it,” Ljungqvist said.