DR RICHARD BUDGETT AND DR ARNE LJUNGQVIST

29 NOVEMBER 2006

  Q200  Chairman: Dr Ljungqvist, do you accept the analysis that this is just the tip of the iceberg rather than the iceberg itself? Do the numbers of people being caught represent the reality of the number of people who are taking illegal substances?

  Dr Ljungqvist: In order to respond to that question, I should first of all comment on the figure you gave because the actual figure is even lower. The 2.5% figure which you gave is the number of adverse analytical findings and amongst those are lots of therapeutic use exemptions, which means that the actual number of athletes who have been punished or are being punished or have been under prosecution for having committed a doping offence is much, much lower. It could even be 50% of the figure you gave. Whether that is the tip of the iceberg in sport or not, again, as Dr Budgett said, I too am in such a position that I would hesitate to make any guess and, since I am a scientist, I ought to be very careful. What I know and what I think is of vital interest is to be aware of the fact that the widest use of in particular androgenic anabolic steroids takes place outside organised sport. In my country, we have found lower gains for use, possession and so forth of androgenic anabolic steroids. We know that the amount of doping substances found by our police forces and at our borders by our customs is way beyond what we find in sport. We know that most of that use takes place outside organised sport/outside elite sport for the simple reason that under those circumstances those people must know that controlled drugs exist and know their current mechanisms whereas, in sport, there is some sort of control. I would not use the terminology that the figures we find in sport represent the tip of the iceberg because we do not have any evidence for that being the case.

  Q201  Chairman: Are there certain countries where guilt is more prevalent than in others and why is that?

  Dr Ljungqvist: Yes.

  Q202  Chairman: Can you give us examples?

  Dr Ljungqvist: Yes, I can. We know that quite a number of those found and finally judged to be guilty of doping offences come from the former eastern European countries. I believe that we have pockets there where the information and education have not reached them, the key people such as coaches, team leaders etc. This is something about which government bodies out there are well aware and it is a fact.

  Q203  Chairman: How are these countries' athletes able to compete on the international stage if that is so well known and so prevalent?

  Dr Ljungqvist: They of course are at risk and some of them are found. We had a major problem with the United States earlier on before USADA (United States Anti-Doping Agency) was created which is now conducting efficient work and, as you know, they have found a number of top athletes in various sports, which is not a surprise to us.

  Q204  Chairman: Dr Budget, would you echo that, that across the world there are certain countries that are significantly more prone to doping than others?

  Dr Budgett: Yes, I think so and it must be a combination of the effectiveness of the deterrent in those countries, hence the United States has improved vastly over the last few years, and the culture.

  Q205  Chairman: Do you think that doping is more prevalent in certain sports?

  Dr Budgett: Yes and you can see that from the statistics. In my own sport of rowing, there is a low prevalence of doping whereas in some other sports, like cycling, there are more cases.

  Q206  Chairman: Why cycling?

  Dr Budgett: I think it is probably the events and the culture of the sport.

  Q207  Chairman: Yet rowing is a sport where muscle bulk is incredibly important. You would think that growth hormones would be used extensively.

  Dr Budgett: It is a different physiological challenge to cycling on the road. It is more like track cycling where there is a lower incidence of doping than there is on the road.

  Q208  Chairman: Dr Ljungqvist, can you explain why cycling has such a prevalence of drug taking? Is it just cultural?

  Dr Ljungqvist: I would say that it is. It is not by chance that the IOC began their fight against doping, it was because of a death of a cyclist at the Rome Olympic Games. That has been the culture for a long period of time. There have been deaths throughout the previous century from the beginning of the century; they did not do much about it; it was accepted as part of the professional cycling tours around Europe. The sporting authorities did not react until it came into the Olympic Games. So, the culture is there. Also, when it comes to professional cycling, it is a sort of a very close family, if I may say so. It is a fairly small group of people, a homogenous group in a sense, and they establish the culture. It is interesting that, when the Erythropoietin came on to the market in the late 1980s/early 1990s, it immediately started being misused by cyclists. We know that. We had evidence before WADA only a week ago by one of the top cyclists from the 1980s who won the Tour de France several times and he stated that EPO was widely used immediately it came on to the market and that it resulted in a number of death cases. Then the cyclists themselves decided to establish rules and have blood testing in order to protect their health.

  Q209  Chairman: Is there any reason to believe that English sport is any different? If we take cycling, is there any reason to believe that our cyclists are drug free?

  Dr Ljungqvist: One should not look at professional cyclists as being English or Swedish or German. They are professionals in teams which are private business enterprises. When it comes to amateur cyclists, I think that the amateur sport in your country and in my country is very different from the professional cycling that we are talking about.

  Q210  Chairman: Dr Budgett, you are obviously nodding.

  Dr Budgett: Yes and I would echo that. I think that the financial side is very important because there is a great deal of money in professional cycling and therefore the stakes are much higher, and that will drive people to cheat.

  Q211  Chairman: Before I finish my round of questions, in terms of who is incentivising athletes to take drugs or other enhancements—and we will come on to some of the other enhancements later, so let us deal with drugs in particular—is it the athletes themselves and the financial incentives or is the coach, the doctors or the medics? Where is the driving force in your opinion?

  Dr Budgett: This really is only an opinion and it is based on a very few cases of people I have talked to who have been guilty of doping offences and, in the two I know best, they were effectively self-driven. I know of cases which have been in the media where it has obviously been either the team or coach where there has been the culture that you were expected to be prepared to take these substances, otherwise you were letting the team down. That I think is a threat. I think that is really in some professional sports and, in the majority of cases, it is clandestine, it is individual, and those athletes spend a great deal of their time and energy covering up and worrying about it, so there are large negative effects even before they get the negative effects from the doping.

  Q212  Chairman: Dr Ljungqvist, where do you think the incentive comes from? Is it from the coaches, the medics or from the athletes themselves?

  Dr Ljungqvist: Certainly there are always rumours circulating amongst the athletes, "Have you heard of this? Have you heard of that? Try this. Try that". I would say that the entourage is possibly even more a pressure group such as coaches and the like because their success is dependent upon the success of their athletes. We have had numerous examples of coaches who have approached scientists with questions such as, "How do I get that? Where are you in the procedure of establishing new drugs?" etc, etc. There was a recent case which related to Great Britain where a former East German coach approached a company here asking for some Erythropoietin genetic material which had ceased to be produced which shows that coaches are out there searching for the latest news.

  Q213  Dr Iddon: Is there not a danger in that, as you put more and more pressure on, which you obviously are doing and we would support you in that, the known HETs, more recently EPOs and blood doping in general, the coaches and the athletes themselves will move to unknown HETs which are possibly more dangerous? We have picked up evidence that people are stupidly taking veterinary growth hormones.

  Dr Ljungqvist: Yes, absolutely. Being a medical scientist myself, I was amazed by the fact that apparently educated athletes even take THG, the designer steroid that was produced by the Balco Laboratory in California. If you manipulate the molecule, we all know that the effects and particularly the side effects may become totally different from what the original molecule would produce. Yet they were taking it. Any medication which goes on to the market is subjected to very careful investigations over a period of eight to 10 years. Whereas, in this case, it was immediately taken by the athletes without ever having been tested and they were really playing with their lives. One of them appeared again in front of WADA a year ago and testified that she had taken it without thinking about it in that way and that was an educated young athlete. It is amazing.

  Q214  Mr Flello: The WADA code is under review. What are the major changes that we might see, if any, following that review?

  Dr Ljungqvist: I do not have a crystal ball in front of me. As you know, the work has just begun. We did have a first presentation at the WADA Executive Committee and Board Meeting 10 days ago by the Code Review Team and they are now circulating to various stakeholders around the world to get their opinion on the first draft that they presented to us. The final outcome may be totally different from the first draft that we saw. I believe that they will review the penalty system which has been criticised for various reasons from various serious sides. I know that the standard penalty for a serious first doping is two years' ineligibility. It is proposed that flexibility be introduced which means that it can rise to three or four years for serious offences, for instance. They are attempting to introduce a more flexible penalty system. The List is believed by many to be possibly the most interesting part of the Code. That is reviewed every year, so that is part of the particular review now.

  Q215  Dr Harris: I think we will come on to the List shortly.

  Dr Ljungqvist: I am Chairman of the List Committee as well and we will try to produce a new draft list at the time of the Madrid Conference next year when the Code is up for a decision. Richard Budgett is also a member of the List Committee and we are discussing this. This is an ongoing discussion since we will have to issue a new List in 2007 anyhow and that will have to be done by the end of September of that year. I believe that the penalty will be an example of the change in the fundamental Code.

  Q216  Dr Harris: Is the feeling out there—and I know that this is anecdotal—that the Code is working well or that there are problems with it and therefore people would expect to see a significant review or is the feeling that what is likely to happen is fine tuning?

  Dr Ljungqvist: If I may give a personal opinion on this, of course the introduction of a more flexible penalty system which would allow a much tougher penalty for those who are the real cheats is not fine tuning, it is a real change. For the rest, it might well be fine tuning because it is the general opinion out there that the Code is functioning well and that it is a major step in the right direction to harmonise the anti-doping rules across the world, across nations and across sport and this is something that we have been asking for as long as I have been in the field which is 35 years.

  Q217  Dr Harris: What about making all articles of the Code mandatory? What is your view on that, Dr Budgett? I think that some are non-mandatory codes.

  Dr Budgett: We have talked about introducing more flexibility. When the Code was formed, personally I think it was a great step forward and very brave for the IOC to hand that over to a combined government/sports organisation which is what WADA is, but of course sport lost some control over anti-doping as a result of that and a number of things have come out of that and we are going to talk about the List later. We have talked about the length of ban and many of us in sport feel it should be four years, particularly Olympic sports. It is ridiculous if someone can come back and compete in the very next games having been caught the first time. The other is the way substances are selected for consideration to be included on the Prohibited List. Therefore, how important is the fact that they may be performance enhancing or are considered to be performance enhancing and it is not explicit in the Code that that is the most important criterion of the three criteria.

  Q218  Dr Harris: We are coming on to the Prohibited List and maybe we will leave those questions until we ask about them but I do have one question around that regarding this current rule that the non-performance enhancing drugs that happen to be unlawful in most jurisdictions, like marijuana and cannabis, are on the List and therefore people can face a two-year ban for taking something that is very common, does not affect their performance generally speaking and is in fact non-criminal in some jurisdictions. Is that still controversial?

  Dr Budgett: Yes.

  Q219  Dr Harris: Would you expand on that, please.

  Dr Budgett: As I say, I think that is the penalty we pay for governments being included in putting the List together, so there is a large political push and now of course it is really difficult to withdraw some of those things like marijuana. Can you imagine the message that might send out and how difficult it is for governments to be seen to be going soft on that sort of thing? Of course, it is completely the wrong way of dealing with the problem in sport to penalise someone by banning them from the sport for two years when really what they need is help. I know that a number of sports do have proper rehabilitation programmes and proper counselling to get athletes through those sorts of problems. It is actually going to be adverse to their performance. In most sports, it will adversely affect their performance.