DR RICHARD BUDGETT AND DR ARNE LJUNGQVIST

29 NOVEMBER 2006

  Q300  Dr Iddon: One of the aims in doing this inquiry, of course, is to make the 2012 Olympics here in London famous for the sporting prowess rather than for the scandals that might emerge from doping. Could you summarise for us what the authorities should do to minimise the use of illegal human performance enhancement techniques for those games?

  Dr Budgett: Education, obviously, first of all.

  Q301  Dr Iddon: Should education go down to the school level, do you think, or should it just be amongst the adult athletes?

  Dr Budgett: I think it should go into all those active in sport, but, in the end, the testing needs to be targeted at those who are doing sport at a very high national and international level.

  Q302  Dr Iddon: The elite athletes.

  Dr Budgett: The elite athletes, absolutely. It is very important that our British team is clean. That is vitally important, obviously. It is also important that we send a very strong message to the rest of the world, and that has to be in cooperation with WADA and IOC. One obvious way of doing that is to have more tests than have ever been done before. That is a tempting and simple way of doing it. As I understand it, there are going to be 4,500 tests in Beijing, so there is a nice rounding of the figure to 5,000, is there not? That would be half of the athletes at the games, as well, so half of them will be tested at some point, which is quite a nice message. But, to come back to what I previously said, they have to be targeted and know they are going to be targeted out-of-competition, so we need to make sure that we cooperate with those anti-doping agencies around the world to test the athletes in the various camps there are going to be in the lead-up to the games.

  Q303  Dr Iddon: Professor, do you agree with that?

  Dr Ljungqvist: Yes. Since you ask me, I feel that I am privileged in having been asked to give some advice. Thank you. First of all, you know, I believe, that during the Olympic Games the IOC is responsible for the anti-doping activities. It is often misunderstood that WADA is doing it. WADA is not. WADA is doing very little of testing; WADA is a supervisory monitoring body which issues regulation standards, et cetera. It conducts some testing on behalf of the nations or federations who do not have much of testing activities but that is about it. We do link up with WADA during the Olympic period—to come back to out-of-competition testing, as I mentioned—from the opening of the village, and we could possibly expand that, but we would have to discuss it. Surely, as Richard Burdett said, the one important part of the anti-doping work for the 2012 games should be to expand the out-of-competition testing programme considerably. It will cost a little but it is worth it, for sure. We saw the benefit of it in Athens. We found the Greek athletes, the famous cases. It was embarrassing but it is a necessity. It is a must. That is one aspect. Then we will have a mechanism in place from the part of the IOC which is routine; namely, that we include the Chief Medical Officer into the International Olympic Committee's Medical Commission as soon as that person has been appointed for the coming games. So the Beijing Chief Medical Officer is already a member of the IOC Medical Commission, so is the Chief Medical Officer of Vancouver, and, as soon as London has appointed, that person will become a member of the IOC Medical Commission and therefore will be continuously updated and kept involved in the planning of the anti-doping activities for the games. The third aspect—and I repeat myself a little—is that it is of the utmost help to have a law in place against doping in the host country. That is a very strong message to the athletes and it is very helpful for all organisations concerned who will be involved in the conduct of the Olympic Games.

  Q304  Dr Iddon: I would like to ask a question now about something we came across in Australia. At the National Institute of Sport in Canberra they follow the athlete's biochemical patterns very, very closely throughout their elite career. They were pushing the idea, which I gather is discussed across the world, of doping passports. The argument is that a given athlete's biochemistry will differ quite considerably from another athlete's biochemistry and it will change during training as they build up to the competition. They are suggesting that unusual patterns of biochemistry in the blood or the urine can be detected by putting all the testing results and all the research results on what they describe as the doping passport. I would like to ask the two witnesses we have here this morning what their feeling is on doping passports.

  Dr Budgett: I think it is a good idea. I have spoken about it to Professor David Cowan from the King's Laboratory. I do not know if he has been a witness here. One of the obvious worries is that athletes will still manipulate that profile but I am reassured that that would be a very difficult thing to do. I think a passport would be effective. It was discussed at the recent IAAF IOC meeting in Lausanne. The resources put into that would be effective and we could show a lead on that in the UK because it would be one extra way of making sure our athletes truly are clean.

  Dr Ljungqvist: I agree. It should be a good tool to have in place. We have tried it in my own international federation, the Athletics Federation. It failed because of the extremely rapid turnover of athletes and keeping track of all those athletes that came and left the elite group was virtually impossible. I would say it is rather a mechanism that you could put in place at the domestic level. It was thoroughly discussed at the recent symposium, particularly with respect to a blood passport for recording parameters—for reasons which I explained earlier—but it is something that should be looked into at the domestic level. We have it in my country for blood analysis, not for further biological parameters, but that is a certainly a very useful tool.

  Q305  Adam Afriyie: Despite having captained the basketball team at university, I was always more noted for my enthusiasm than my ability at sport and I am very enthusiastic and optimistic about what Britain can achieve at the 2012 Olympics. I want to turn to the more upbeat, optimistic side of human enhancement technologies rather than the cheating side and the doping side. We had some evidence from Anna Casey of QinetiQ. She said that it would be naive to think that athletes/sportsmen will not be using legal supplements and legal enhancement technologies to maximise their performance. Who is responsible for or takes a view on how to help athletes keep abreast of legal human enhancement technologies and supplementation?

  Dr Budgett: In the UK there is no single body. It will depend on the professionals involved in that sport. I think cycling is quite a good example because they have to be open about the way in which they will go right up to the line of what is permitted and they will spend all their efforts on making sure that all the training, all the equipment, all the science is absolutely perfect, without using anything that is prohibited; the rationale being that those athletes who are cheating will be at a disadvantage because, as I mentioned earlier, they are spending an awful lot of their effort avoiding detection, worrying about detection. If you are focused on performance and you know you are producing a clean performance, in fact your performance can be just as high. Ethically and morally that is the right thing to do. We are talking about excellence here, so it is right to pursue that excellence within the framework of the rules. I do not think there is anything wrong with that. Nationally, the British Olympics Association and UK Sport work together. For the sake of our Olympic sports, we have seminars for the support staff dealing with cutting-edge stuff. It is not just the normal substances, where you might go to a sports medicine doctor; we are talking about cutting-edge ideas and ways of working. That is one way of dissipating it, but each sport is going to have different needs, so it is often on a sport-by-sport basis and it depends on the quality and experience and inspiration of those support staff.

  Dr Ljungqvist: From an international point of view, the responsible body for dealing with the aspects which you are mentioning is the IOC Medical Commission. Earlier on, the IOC Commission was mostly focused on the anti-doping fight. That was why the Commission was created back in the 1960s, for the reason I gave earlier, after the death of the cyclist. Since WADA was born, the IOC Medical Commission has reoriented its attention and work, and it is now the medically responsible body for taking care of the safety of the athlete when they conduct their athletic performances under the existing rules. We are issuing position statements after having recruited the necessary international expertise in various fields. Those are always published on the website but also circulated to all the stakeholders. Could I give you some examples of what has been achieved so far. During the last few years, we have issued a statement on how to protect and avoid concussion in sport (boxing, soccer, et cetera); we have issued a position statement on how to prevent and take care of the problem of sudden death in sport—which has occurred, you know, quite a few times over the last few years; we have issued a statement and recommendations with respect to the use of food supplements; we have issued a statement on the problem with a female athlete triad, to avoid that very problematic medical disorder; and we are about to issue a statement in a few weeks on sexual harassment and abuse in sport, which is an ethical problem in sport. The body is there.

  Q306  Adam Afriyie: How would you describe the attitude of the British Olympic Association and the International Olympic Committee towards legal human enhancement technologies or supplementation? Would it be: "Yes, go ahead, use everything that is legal to the maximum to achieve maximum of your abilities"? Or is it a slightly more cautious outlook?

  Dr Ljungqvist: To expose an athlete to the strain that elite training and elite athletic performance means today is risk-taking in terms of health, therefore you have to be aware of the risks and have a mechanism in place to prevent those risks from occurring. Internationally, as I have said, the IOC Medical Commission feels that responsibility, and the medical people involved at the domestic level in domestic sport feel the same, for sure. As long as the mechanisms that they are using for performance enhancing are accepted and not banned, it is automatically okay.

  Dr Budgett: I would say that we are cautious and sceptical as well. As you will know, there is an awful lot of methods and substances out there that are put forward with pseudo-scientific justification—"You follow this cycle and it must help"—and we know that in effect it does not. I am also sceptical about some of the things that have been proven to be ergogenic; for instance, creatine. Most of the studies there have been done on college athletes, who are not our very elite athletes. When, for instance, the bob-sleigh team I looked after used it, not many of them seem to have benefited. I think it is because you are dealing with a different group here. Everything is about as optimum as it can be, so it is more difficult to get that extra enhancement through taking supplements because of the normal homeostasis.

  Q307  Adam Afriyie: Professor Ljungqvist mentioned the position papers and advice being given on concussion, sudden death in sports and some of the health issues surrounding food supplements. Is there anything that you see that is a more positive approach to the use of the legal performance enhancement? Are there suggestions or advice as to which things may be helpful and which things may not be helpful?

  Dr Budgett: Yes. We have position statements as well. We still have quite a restrictive statement on the use of supplements, mostly because of the concern that they are contaminated—and that is another whole discussion and well-known problem.

  Q308  Chairman: We will move on to that.

  Dr Budgett: I would also mention that the IOC have produced a medical code on the ethics of looking after athletes and the health of athletes. The British Olympic Association, I think, are the first `national' Olympic committee to endorse that and sign up to that IOC medical code, and it is about putting the health of the athlete first. Of course, if you do not have a healthy athlete, they are not going to perform in the long term, so we have a duty to protect them. I also feel that athletes are a very vulnerable group, in that they are going to be looking around desperately, worrying that somebody else has an edge, so you have to have a structure in place so that they can feel completely confident that everything possible is being done for them. If a supplement is needed, that will normally be under dietician, nutrition or medical guidance, effectively, for a medical reason. It is very unusual for athletes to need a supplement. I would never go out to a squad and say, "You've all got to take magnesium." It would be ridiculous. We spend all our efforts making sure they get the appropriate advice and follow it on diet, fluids, training and recovery.

  Dr Ljungqvist: May I add one thing to that, so that I am not misunderstood here. I said I issued a position statement on, for instance, food supplements. If you go into the details of what we have said, we have said: "Do not take them unless you can prove that you need it". That is important.

  Q309  Adam Afriyie: What view does WADA take to the researching of new supplements? I know you do not commission it yourself, but what view do you take of research into human enhancement technologies and substances, and, in particular, substances which were on your monitored list? Clearly there may be some advantage to conducting research into these substances, but what view does WADA take?

  Dr Ljungqvist: In WADA we have limited funding for research. Although between 20% and 25% of WADA's budget goes to research—which makes me happy—the total sum is not that high. It is around $5 million. We are using that based on a list of criteria for which we can use this amount of money. That is for developing methods for the detection of doping substances. Then we made a list of priority for which people can apply. But we are not conducting research into how to improve performance and how these substances will be working on the human body. We do not feel that is our responsibility.

  Q310  Adam Afriyie: We had some evidence from Mr Brewer that WADA may be withdrawing accreditation to labs. I think there is a kite mark system or something where WADA accredit supplements or products that have been tested and shown to be contaminant free. Is that the case? Are you going to stop the accreditation of these labs, and, if so, what is the rationale behind that decision?

  Dr Ljungqvist: The rationale behind that decision is that, if you test certain food supplements or are asked to test them for making sure whether they may be contaminated or not, if you find that they are not, you cannot tell that the other batches will not be contaminated so you may issue false reports and misleading reports. We have told the laboratories not to become involved into an area which is so poorly regulated at the national levels.

  Q311  Adam Afriyie: You would see it more as a national level activity as opposed to a WADA activity.

  Dr Ljungqvist: Yes, if so.

  Q312  Adam Afriyie: When does this policy come into play? I assume labs are still accredited at the moment.

  Dr Ljungqvist: It was established very early. We had a particular working group that was working for the first two years of WADA's existence which looked into the whole area of food supplements. As you know, we gave one of the laboratories the task of investigating the food supplement market. It was the Cologne Laboratory which conducted the research and accumulated large numbers of food supplements via the internet and various producers. They found that between 15% and 20% of the food supplements were contaminated by or contained banned substances which were not indicated on the labels. This is an unregulated market. We simply advised athletes of the risk of taking such things. That is what we can say.

  Q313  Chairman: Is the key rationale that a WADA-accredited laboratory, like the King's Laboratory in London, cannot test any supplement so that you can be assured there will be no contamination of the samples which come from that list.

  Dr Ljungqvist: Yes. That is the conditions today. I know that some laboratories wish to be able to make specific investigations into specific situations, but, if so, they had to apply with WADA to be able to do that.

  Q314  Adam Afriyie: My final question is this. In terms of the legal human enhancement technologies and substances, is a positive note. What would you encourage athletes to do in order to enhance their performance using legal methods?

  Dr Budgett: I am afraid I do not have any magic answers. I think it is a matter of optimising their training and optimising their recovery. There are going to be different situations. For instance, you could use a high altitude chamber if you are injured—and we would use this at the moment. Say you are a rower and you have injured your back or your legs, you can still use your arms but it is very difficult to do the same intensity of workout just using your arms. If you go into a high altitude chamber, cardiovascularly you can be forced to work much harder, so you get the same training effect, so you can maintain your training while you are recovering. There are examples like that, but, generally, it is a matter of optimising training and optimising recovery, which is all about diet, fluids and time to recover.

  Dr Ljungqvist: My answer would be very short. I would recommend the athlete to have a good and honest coach who plays in accordance with the rules and learns with the athlete to play in accordance with the rules.

  Q315  Chairman: Professor Ljungqvist, that is a fantastic quote on which to finish this session. Could I thank you and Dr Budgett very much indeed for what has been a really useful session for us. Thank you very much indeed for the honest way you have replied to our questions—not that I am suggesting witnesses are not honest, I should put on the record!

  Dr Turner: Evasive sometimes.

  Chairman: Thank you very much.