Memorandum from Department for Culture,
Media and Sport and UK Sport
1. INTRODUCTION
1.1 With permission from the Committee Clerk,
UK Sport and the Department for Culture, Media and Sport (DCMS)
are pleased to submit joint evidence to the Science and Technology
Committee enquiry into Human Enhancement Technologies in Sport
(HETs).
1.2 As UK Sport is the agency appointed
by Government (through the DCMS) as the National Anti-Doping Organisation
for the UK, it was felt that a joint submission would be logical
to avoid unnecessary duplication of information in separate UK
Sport/DCMS responses.
1.3 The field of Human Enhancement Technologies
(HETs) is vast and constantly evolving, with new threats and challenges
regularly presenting themselves. For the purpose of this submission,
UK Sport and the DCMS have chosen to focus on the HETs that are
currently considered by UK and international experts as the most
likely threat to sport leading up to the London 2012 Olympics.
1.4 Priority was given to those HETs which
are considered to be prohibited in sport, as determined by the
World Anti-Doping Code Prohibited List 2006. It is recognised
that a wider ethical debate is ongoing into currently permitted
HETs, for example hypoxic chambers.
1.5 The structure of the submission is based
on the four main topic areas as highlighted in the Committee's
Inquiry announcement.
2. TOPIC 1
The potential for different HETs, including drugs,
genetic modification and technological devices, to be used legally
or otherwise for enhancing sporting performance now and in the
future
2.1 Following detailed consultation with
a number of leading experts, we have identified the issues that
could pose a significant threat to the spirit of sport as London
prepares to host the Olympic and Paralympic Games in 2012:
— Human Growth Hormone; and
2.2 Following the 2003 BALCO investigation
and the discovery of the designer drug Tetrahydrogestronone (THG),
designer drugs are considered by scientists to be a real threat
to the integrity of sport. (US-based lab BALCO was identified
as the source of the previous undetectable steroid THG, which
resulted in Dwain Chambers among others receiving a two-year ban.)
2.3 The threat lies in designing new drugs
to modify gene transcription by: interacting with intracellular
receptors in common with other steroids; binding to hormone receptor
elements; and activating the synthesis of one or more proteins
that may be either enzymes or structural proteins.
2.4 In addition, designer stimulants acting
on the Central Nervous System or the cardiovascular system to
raise aggression, confidence and alertness are also a concern
to scientists.
2.5 There is potential for unscrupulous
scientists to design new, undetectable substances specifically
synthesised to "beat the system". In addition, there
will continue to be a willingness on the part of some athletes
to use themselves as "lab rats" and take trial substances
designed for legitimate medical therapies that have not passed
the clinical, experimental stage.
2.6 Lessons have been learnt as a result
of BALCO. Although THG was an agent that could, in theory, have
been detected by the system, it was a designer synthetic agent
that had unique properties when compared with any prohibited substances
that were, at the time, being tested for. Scientists and their
systems are programmed to look for and detect specific substances
or anomalies within the test results. With THG, the steroid fell
outside the standard detection range and therefore went undetected
until an anonymous coach made its existence known.
2.7 The further development of assays that
detect a drug's effect on the body's receptors are techniques
that could provide a method of detection in the future to significantly
help combat doping in sport. Likewise, unscrupulous scientists
will be able to utilise this knowledge to create new designer
drugs.
2.8 Recently, a third-generation molecule,
Continuous Erythropoietin Receptor Activator (CERA), incorporating
a large polymer chain, has been developed. CERA has an elimination
half-life in humans that is considerably longer than the half-life
of either epoetin or darbepoetin alfa. CERA may also have different
receptor binding characteristics and pharmacology from other erythropoietic
agents. CERA is currently in phase III clinical trials.
Hormones
2.9 The mechanism of action on the receptors
is particularly concerned with small peptides acting as hormones
including Growth Hormone and EPO.
2.10 Growth Hormone is a 191 amino acid
long protein that is metabolised in the liver with a plasma half-life
of 12-45 minutes. Humans are insensitive to cross-species growth
hormones, so only human growth hormone can be used. Recombinant
human Growth Hormone is a very real threat within sport. Synthetic
growth hormone (Somatropin) is available to be used clinically
and to be abused by sportsmen and women.
2.11 Growth Hormone acts by binding to receptors
that can be found on the surface of every cell in the body, stimulating
the production of several polypeptide mediators thus stimulating
protein synthesis and growth. It is desirable to athletes because
it may aid recovery from injury, promote strength and burn fat.
2.12 Growth Hormone is currently likely
to be limited to elite level athletes as it is extremely expensive,
difficult to attain and requires expert medical administration.
However, there is no doubt that those athletes that do source
and self administer the drug have the potential to make the playing
field considerably uneven.
2.13 Another such threat is the glycoprotein
hormone EPO that regulates red blood cell (RBC) production. EPO
acts on erythroid progenitor cells in the bone marrow which have
specific receptors for the hormone. Eryththropoesis takes place
in haemopoietically active bone marrow and then the mature blood
cells are released into the circulating system to provide the
athlete with a greater oxygen carrying capacity.
2.14 When used, EPO has potential effects
that could benefit an athlete's performance for weeks. Those well
versed in misusing the substance also have the ability to control
the amount of EPO they use, keeping their levels below the reported
threshold for an adverse finding but promoting red blood cell
growth nonetheless.
Blood Doping
2.15 As the detection and understanding
of EPO has become more advanced, the mechanisms used by athletes
to enhance their oxygen carrying capacity has reverted back to
blood doping. Similar advances in technology have given added
confidence to this procedure as the risks involved have reduced.
2.16 Autotransfusion and use of other substitutes
such as haemoglobin-based blood substitutes and micro-encapsulated
haemoglobin are being incorporated into this technique. The difficulty
lies in the fact that an athlete growing and using their own blood
makes it impossible to detect if the levels are below those reported
for an adverse analytical finding.
2.17 Blood doping is used to enhance performance
in endurance events by increasing the RBC content and therefore
the oxygen carrying capacity of the circulatory system of an athlete.
Gene Therapy
2.18 The most publicised threat to fair
play in sport is gene doping. The advent of gene therapy is a
massive advance in medicine and will hopefully in the future be
able to save and change the lives of many individuals who currently
suffer from irreversible and incurable diseases. As with previous
medical advancements, drug cheats have seen this as an opportunity
to enhance performance without being detected.
2.19 The possible benefits of gene doping
for athletes are increased production of a naturally occurring
substance such as IGF-1 to stimulate muscle growth, speed healing
and repair, or having an effect on other genes causing them turn
on or off as required to enhance performance.
2.20 Is this HET a threat to sport? Currently
the experts suggest not as gene therapy is still in its infancy.
Medical use of gene therapy has been limited and the success variable.
In many of the patients the technology was used in, the effects
were either negligible or negative. However for some there were
serious long term health consequences.
2.21 The potential of gene doping is currently
over-played, although it will depend on how genetic modification
is defined. Pharmacological manipulation of gene expression, as,
for example, in the use of selective androgen receptor modulators,
is likely to be a far more powerful tool.
2.22 By 2012 gene doping could be a very
real threat therefore and, as it utilises natural body systems
and manipulates the host's DNA, it will be difficult to detect
and prove.
3. TOPIC 2
Steps that could be taken to minimise the use
of illegal HETs at the 2012 Olympic Games
3.1 To combat these threats and to guard
against any potential threats in the future, a multifaceted approach
of prevention, deterrence and detection is necessary. While obviously
a core element, an effective testing programme alone is not enough.
3.2 The harmonisation of standards for testing
and laboratories is fundamental. As drug testing procedures and
programmes for sport fall into line with the World Anti-Doping
Code (WADC), a more intelligent and coordinated approach to testing
globally will be achieved. With no advance notice out of competition
testing as the priority of the Code, anti-doping organisations
are working towards the implementation of athlete whereabouts
systems and will continue to increase the requirement on athletes
to be available for testing at any time. UK Sport has operated
an out of competition testing programme with sports in the UK
for more than 10 years and is currently conducting out of competition
testing on over 50 sports.
3.3 Over 50% of all tests UK Sport conducts
are now out-of-competition tests, with the allocation of these
being increasingly governed through the concept of "intelligent
testing". This focuses on key triggers within athletes' performance
and training cycles which identifies areas of "maximum risk"
of potential doping. This could include, for example, athletes
returning from injury or preparing for major events. Through intelligent
testing, UK Sport is able to maximise the deterrent effects of
the programme.
3.4 As all national anti-doping organisations
begin to utilise the World Anti-Doping Agency's (WADA) Anti-Doping
Athlete Management System (known as the ADAMS database), they
will be able to share intelligence on athletes that regularly
travel abroad to train and compete, avoiding any such "doping
havens" from being established. UK Sport has reciprocal testing
arrangements with a number of countries and on an annual basis
carry out testing in the UK for several overseas counterparts.
3.5 Global standards for laboratories are
imperative in achieving consistency in analysis and detection
techniques. This encourages laboratory experts to work in partnership
to share their knowledge, which allows laboratories around the
world to analyse and detect substances or methods that may have
otherwise gone undetected.
3.6 The UK's two WADA Accredited Laboratories
add great value to the global efforts to rid sport of doping.
Professors David Cowan (King's College London) and David Hall
(HFL) regularly attend international symposiums on laboratory
and other scientific issues; they work in close connection with
UK Sport to contribute to the UK's annual response to the Prohibited
List review and WADC consultation; and they conduct essential
research for detection of prohibited substances and methods.
3.7 Education and Information also has a
critical role to play as a tool that can influence the attitudes,
values and behaviours of athletes:
— it safeguards clean athletes from
making inadvertent mistakes by increasing their knowledge of anti-doping
rules;
— it allows young athletes to develop
the skills and values necessary to make positive choices about
competing drug-free; and
— it enables anti-doping organisations
to expose those athletes who do not to abide by the rules by eliminating
any opportunity for excuses.
3.8 In 2005 UK Sport launched the 100% Me
programme to promote the clean sporting success of athletes committed
to competing drug-free. 100% Me:
— Provides a platform for current British
athletes to demonstrate that you don't need to use drugs in sport
to be successful.
— Ensures that members of the sporting
community can access the information and advice necessary to make
well informed choices about anti-doping.
— Minimises the risk of inadvertent
doping, and in turn, make apparent, any athlete intent on dodging
the anti-doping system.
3.9 Since May 2005 UK Sport, in partnership
with the Home Country Sports Councils and national governing bodies,
has been able to reach over 12,500 athletes and support personnel
through 100% Me, train and accredit 176 tutors from the British
sporting community to deliver education to their members, and
sign 36 athlete ambassadors from over 50% of sports on the national
testing programme. 100% Me is widely recognised, by WADA among
others, as a world leader in terms of athlete education.
3.10 In 2002, UK Sport launched the Drug
Information Database—an online tool that enables athletes
and support staff to check whether or not any pharmaceutical products
they are taking contain prohibited substances. This has proved
to be an invaluable tool for British athletes, and has recently
been taken up by our counterparts in Canada. Potential partnerships
with other nations are now being pursued.
3.11 The future success of any anti-doping
programme rests on continued efforts in scientific, medical, social
and behavioural research and development.
3.12 Since 2001, WADA has committed more
than US$28 million to scientific research. WADA is committed to
increasing the volume of research dedicated to developing new
and improved detection methods for performance-enhancing substances
and methods.
3.13 In the UK, HFL Ltd, Nottingham Trent
University and University College London Medical School were granted
£212,000 to conduct research into the application of cellular
chemistry and proteomic approaches to the detection of gene doping.
3.14 King's College London worked with Southampton
University on a project titled GH-2004 which looked at the development
of a methodology for detecting abuse with growth hormones in sport.
3.15 To better inform the education and
information anti-doping programmes of NADOs, it is critical that
we continue to develop our understanding of the attitudes and
values that shape the behaviours and decisions of athletes that
move up through the performance pathway.
3.16 In 2005, WADA contributed over US$60,000
to social and behavioural research. This was the first year that
grants were awarded for social science research and WADA has committed
to further contributions in this area.
3.17 Amongst other research being conducted
globally UK Sport has also committed to a long-term research programme
between 2006 and 2012. This includes:
— Funding a scientific study into the
detection levels needed to identify contaminants in a supplement
that may give rise to an adverse analytical finding.
— The establishment of a network of
social, scientific and medical academics and practitioners to
develop a long term anti-doping research strategy for the UK.
— Conducting the first ever longitudinal
study into the attitudes, values and behaviours of talented athletes
towards anti-doping.
4. TOPIC 3
The case, both scientific and ethical, for allowing
the use of different HETs in sport and the role the public, Government
and Parliament in influencing the regulatory framework for the
use of HETs in sport
4.1 The Government fully supports the anti-doping
campaign as it makes a significant contribution to protecting
the value, image and integrity of sport across all its activities.
4.2 The Government believes that the use
of performance enhancing substances and methods is cheating, contrary
to the spirit of fair competition and damages the value and image
of sport.
4.3 The Government engages with anti-doping
on two fronts. Firstly, through funding a National Anti-Doping
Programme, run by UK Sport, that tests elite athletes for prohibited
substances and methods and educates them on how to train and compete
free from drugs.
4.4 Secondly, by entering into international
agreements, and fulfilling its obligations under these agreements,
which support WADA and the World Anti-Doping Programme in leading
governments and sport in the fight against doping.
4.5 These agreements create obligations
on the Government to contribute to the international effort to
tackle drug misuse in sport which the sporting community would
be unable to solve without government assistance. For example,
the Government aims to reduce the trafficking of doping agents,
and supports those sports that comply with anti-doping rules and
procedures that meet with international standards.
4.6 The UK was one of the first governments
to become party to the Council of Europe's Anti-Doping Convention
(1989).
4.7 This was followed by the Government
becoming one of the first signatories to the Copenhagen Declaration
on Anti-Doping in Sport (March 2003).
4.8 More recently, the Government has supported
the development of an international convention on anti-doping
which resulted in the UNESCO International Convention against
Doping in Sport being adopted at the UNESCO General Conference
in October 2005.
4.9 The UNESCO Convention is a major step
forward as it imposes a legal obligation on all governments to
eradicate doping in sport.
4.10 Following receipt of the authenticated
text of the UNESCO Convention in January, the Government completed
the ratification process and deposited an Instrument of Ratification
with UNESCO on 25 April.
5. TOPIC 4
The state of UK research and skills base underpinning
the development of new HETs and technologies to facilitate their
detection
5.1 The global efforts in research and development
for anti-doping are varied. WADA has contributed millions of dollars
to research since 2001 and will continue to do so in the future.
Examples of the areas of interest for scientific research as funded
by WADA are:
— Compounds/Methods Enhancing Growth.
— Compounds/Methods Enhancing Oxygen
Delivery.
— Exogenous and Endogenous Anabolic
Steroids.
— Projects Relating to the Prohibited
List.
— Gene and Cellular Technologies Applied
to Sports.
5.2 In the UK, there is a well established
partnership between UK Sport, the WADA Accredited Laboratories
and universities conducting anti-doping research. UK Sport has
recently employed an Anti-Doping Information Officer who communicates
regularly with WADA on relevant issues in order to respond to
enquiries about substances and methods.
5.3 UK Sport nominates experts for national
and international committees in order to broaden the experience
and knowledge we have access to. For example, Dr Richard Budgett,
Chief Medical Officer of the Olympic Medical Institute, sits on
the WADA Prohibited List Committee.
5.4 David Cowan has previously sat on and
been invited to the WADA Laboratories Committee meetings. He is
also involved in the research around Compounds/Methods Enhancing
Oxygen Delivery—"GASEPO2- A software tool for analysis
of EPO images after isoelectric focusing and double blotting"
Research Group.
5.5 Following on from GH-2000 study that
has shown a test for GH using GH-dependent markers of GH action
is feasible, GH-2004, lead by Kings College London and Southampton
University, aims to validate a test for growth hormone abuse based
on the measurement of two markers (IGF-1 and P-111-P).
5.6 HFL's Gene research is in its early
stages but is already proving to be an intriguing and fascinating
area of research.
6. CONCLUSION
6.1 The recent systematic doping programme
led by BALCO highlighted the grave reality of the lengths some
athletes will go to in order to succeed in sport. Not only does
this threaten the health and safety of athletes, and possibly
athletes too young to have the ability to know the consequences
of their choices or the choice of their coach or doctor, but it
seriously threatens to undermine and damage the integrity of sport
within society.
6.2 UK Sport is proud of the part it has
played both nationally and internationally in the fight against
doping in sport. With the support and backing of the DCMS, UK
Sport has been able to implement a world class anti-doping programme
of prevention, deterrence and detection.
6.3 UK Sport is recognised as a world leader
in this field. Its standing internationally, and the level of
expertise at its disposal nationally, ensures the UK is well placed
to benefit from future breakthroughs in combating the threat of
HETs outlined above and others that have yet to be discovered.
May 2006
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