The Athletics Biological Passport (ABP) programme of the World Anti-Doping Agency (WADA) will be launching a new module to detect human growth hormone early next year. Dr Reid Aikin, the Director of the Asia/Oceania office of the WADA, is one of the leading experts who is part of the symposium on WADA's ABP hosted by National Anti-Doping Agency and National Dope Testing Laboratory in New Delhi. The Associate Director in WADA's ABP, talks about its effectiveness in detecting and how it can act as a deterrent and more during an interview over the phone. Excerpts
Importance of ABP in the present day context where doping is evolving
Well, ABP is one tool in anti-doping. It is one of many. There is testing, investigation, education and so on. How is the ABP helpful?
It can help direct those other programmes. It is a tool about translating data into actions. It uses the biological data coming from samples and helps anti-doping organisations (ADOs) to decide on different courses of action. These actions could include whether to launch an investigation or to do specific testing or to pursue anti-doping violation (ADV) sanctions based on the passport as well.
There is evidence of increase in blood doping... like EPO, human growth hormones, etc. Even in India the trend is noticeable. Is ABP an effective tool in detecting use of such substances? Can it act as a deterrent?
At present, the ABP is there to detect two main substance classes. The Haematological Module of the ABP is used to detect blood doping, whether it is transfusion or whether it is EPO. And the Steroidal Module helps to detect steroid doping, different types of steroids. (Steroidal module includes Isotope Ratio Mass Spectrometry (IRMS) analysis to detect natural endogenous steroids administered exogenously: WADA). We are also launching in 2023, the Endocrine Module that will target growth hormone doping. To answer the question, EPO and doping is not going to go away. This is something that is very much in use. But if you look at populations that have the passport implemented for a long period of time, the use does go down. You see a change in the nature of this passport and the prevalence of positives. When you look at populations where there is ABP, amateur, national level where athletes are not tested heavily, there is a higher prevalence of substance use here. So it really depends on the amount of testing, whether you give a strong impact or not.
International Federations like World Athletics have made it mandatory. Is there indication that the curve is going down?
If you look at the international federations they are dealing with the entire planet. I think in terms of their trends, it is very regional. There are certain countries that have a doping problem and they no longer do. So their trends have gone down. Others are being tested more and are seeing more cases. Kenya is an example of that. They implemented a laboratory in Kenya with the ability to carry out testing for the blood module of the ABP. That really helped. As a result, there are many more samples and we are seeing more positive cases. It depends on the ability to test but once testing happens, it has a positive effect as a deterrent.
Does ABP help in detecting hyperandrogenism or you don't go into this detail?
It is possible to detect hyperandrogenism. The beauty of ABP is that we are publishing the base limit and then we are conjoining the limits within which the individual markers could fluctuate and why so. There is a possibility but that is not the purpose of ABP. Then it's up to the experts and the organisations to contact the athletes if there are any medical conditions on the athletes side that needs to be addressed.
How is WADA addressing the issue of micro-doping and designer drugs that have very small windows to detect like some growth hormones?
If an athlete is looking for a long-lasting impact on, say, blood doping, that will require an increase in the amount of RBCs. We would detect regardless of the substance or method they use. If there is a significant increase, we will be able to detect that and flag it using the ABP.
If substance classes don't fall into those detected by the ABP, that is still very much a lab detection issue. As you say, the window of detection is critical. We hope that as athletes reduce doses, it's reducing the effect. If you have a lower dose of a substance, the effect will be less. So as athletes go to lower doses or micro-doses or reduced timing of the use, that's a win for anti-doping. It's not beating the system but having less effect. It's less effective than their doping programme. I want to add. If there is an indication of use of substances with a short detection window, that could, say, come from different investigations or different sources of information. Now, the anti-doping organisations have the ability and are authorised to test the athletes 24 hours seven days a week. Earlier, there was a window from 6am to 10pm. Because of this very short detection window, there was that adaptation of the code and now is possible, of course with a justification, to test the athlete during the night, for example.
How do such symposiums help you?
Our goal at WADA is two-fold. We develop the ABP as a tool. As I said before, by increasing the number of substances, we can detect how well it detects them. We develop how the ABP is used globally by ADOs. That leads us to capacity building, an education programme and this type of symposiums (is useful) to both of those goals. On one end, we get to interact with scientists, laboratory personnel; the management units that help administer these passport programmes, more effectively. Also get to meet and interact with different ADOs. There are more than 200 ADOs worldwide running ABP programmes with some more experienced than others.
Your goal in the next two years?
First, we launch the Endocrine Module at the beginning of next year that will help to detect human growth hormone doping or anything affecting the growth hormone. We also have some new steroid markers coming out, to be measured in blood at the beginning of next year. Now the steroid markers are measured in urine, we are going to add complimentary markers. There's continuous research to find new markers within existing modules or expand into new ones.
Apart from blood doping or usage of EPO and the steroidal model you talked about, does it help to detect any other infractions?
The Haematological Module measures fluctuations in those blood parameters and anything that would modify them. Substance like you said transfusion or anything that would stimulate red blood cell production or erythropoiesis... Within that class there is EPO (erythropoietin), there are some other substances... Many of these are detected by the labs very quickly.