It has been 12 years since Lance Armstrong confided to Oprah Winfrey that his seven Tour de France titles were a lie.
Those wins came between 1999 and 2005, the first only 12 months after the Festina Affair, where doping products were found in a soigneur’s car en route to the Tour’s Grand Départ in Ireland.
Both episodes shook the sport. Then came Operación Puerto, the Spanish police operation against the sports doping network of Dr Eufemiano Fuentes, which came to light in May 2006.
That was nearly 20 years ago. Since then, there have been ‘lesser scandals’ such as Operation Aderlass (from 2019) and the ongoing Operation Ilex led by the Spanish authorities, but in both cases there was no suggestion that the riders at the WorldTour top table were implicated.
It begs two questions – is the sport cleaner than ever, and, if perceived as not, where are the gaps in the anti-doping system?
“No evidence uncovered”
Rob Parisotto is an Australian stem-cell scientist who pioneered the first test for EPO (the blood-booster erythropoietin) and the Athlete Biological Passport (ABP).
We’ll come back to both EPO and the ABP shortly, but what’s Parisotto’s macro view of the current ‘healthy’ situation?
“It’s difficult to believe one way or another that exceptional performances are ‘clean’ as a result of freak physical prowess, or artificially enhanced,” he says.
“On the one hand, there have been performances that are unbelievable; on the other hand, no evidence of cheating has been uncovered.”
“Recently, there’s been much publicly available power data from many in the professional peloton that significantly exceeds that of known dopers from years gone by, but again there’s no evidence of impropriety,” Parisotto adds.
“Whether such performances are down to natural ability, doping or even the use of motor doping [having a hidden motor in your bike] is not answerable right now, but who knows, maybe in the future things will be revealed.”
Or maybe Tadej Pogačar and his team, for example, have perfect equipment, training and nutrition, and he has the genes of a god.
The Slovenian, like his peloton-leading contemporaries, hasn’t given cause for suspicion, and if he had, you’d hope it would’ve been flagged up by the ABP.
Effectiveness of the ABP
The ABP, or Athlete Biological Passport, is arguably anti-doping’s strongest weapon against the cheats.
Because of cycling’s litany of high-profile drug scandals, it was rolled out in our sport first, in 2008, before being fully adopted by WADA (the World Anti-Doping Agency) in 2009.
Unlike Parisotto’s earlier EPO test, which targeted direct markers of doping, the ABP looked indirectly, meaning a new costly test didn’t have to be devised for every new EPO drug. Key to these indirect markers were, and remain, reticulocytes.
“When you inject with EPO, it stimulates the production of reticulocytes, which are new red blood cells, meaning a rider has significantly higher levels of reticulocytes than ‘normal’,” says Raphael Faiss, research manager at the Centre of Research and Expertise in anti-Doping Sciences (REDs) at the University of Lausanne.
“When a first sample is collected, upper and lower thresholds are determined with population-based average benchmarks. These individual limits are then adapted based on each athlete’s values as additional samples are taken.”
The Athlete Biological Passport also features what’s called an ‘off-phase’ component.
Once a rider stops taking EPO, their body responds by reducing the normal production of red blood cells in search of homeostasis.
Again, that leads to lower reticulocyte values than normal. Imagine a mean central horizontal line with upper and lower lines. If the reticulocyte levels tip over or beneath these, it could be a sign of doping.
A 2010 research paper illustrated the positive impact of the ABP. Mario Zorzoli and Francesca Rossi’s ‘Implementation of the biological passport: The experience of the International Cycling Union’ found that from 2001 to 2007, around 10% of samples showed reticulocytes in the extreme range of either below 0.4% or over 2%. On introduction of the ABP, this figure dropped to between 2% and 3%.
“When the ABP started, you were having many athletes turn up with [unusually] low levels of reticulocytes, because everyone stopped taking it during competition,” says Faiss.
“But then athletes adjusted their practices. They started to reduce how much EPO they were taking – in other words, micro-dosing.”
According to research, the first-generation, higher doses of EPO resulted in haemoglobin and reticulocyte levels that were 1.7 times that of micro-dosing – which is significantly lower, but still enough to improve performance, with a Danish study showing a 5% improvement in time-trial effort after micro-dosing.
“It’s not perfect because [micro-dosing] is harder to pick up, but you can say that the ABP had a positive effect because it reduced the magnitude of EPO taken,” says Faiss.
“That’s much better from a health standpoint.”
A head for illegal heights
Blurring the micro-dosing picture further is altitude training. Ostensibly, micro-dosing and altitude training aim to achieve the same goal – to increase levels of EPO, which then create higher levels of red blood cells, which can grab onto higher levels of oxygen to fuel working muscles and help you ride faster and longer.
A 2022 paper by Jonas Saugy, titled ‘Altitude and erythropoietin: comparative evaluation of their impact on key parameters of the Athlete Biological Passport: a review’, revealed that an athlete’s blood profile when micro-dosing was indistinguishable from those identified after hypoxic exposure. If the anti-doping authorities notice a blood skew at altitude, it can be explained away by the rarefied air rather than any nefarious activity.
However, it’s not only for EPO that altitude can be used as a backdrop for concealment.
“There are also reports of athletes in the Aderlass [bloodletting] case who were extracting blood at altitude to transfuse back at sea level, because altitude stimulated a naturally accelerated regeneration of red blood cells,” says Faiss. “Some athletes are certainly creative.”
So, altitude creates gaps in the ABP. It’s something WADA is aware of and has funded research into in search of a solution.
One such piece of research by Nikolai Baastrup Nordsborg, the head of nutrition, exercise and sports at the University of Copenhagen, showed that genetic markers of EPO were significantly higher when micro-dosing compared to altitude training.
“Ultimately, the ABP has lost some of its gloss over the years, but still remains a useful intelligence tool and is able to flush out the more obvious cases,” says Parisotto.
“Whether one is abusing EPO, blood transfusions, hypoxic inducible factors (eg Roxadustat anti-anaemia medication) or even artificial red blood cells (in the not-too-distant future), the ABP is still a great warning system prior to targeted testing protocols.”
Aping the system
Those targeted tests are undertaken on behalf of the UCI by the ITA (International Testing Agency). That’s on a micro level. On a macro level, athletes are monitored by the ADAMS. “This is the Anti-Doping Administration and Management System,” says Faiss.
“It’s where the ABP sits and also an athlete’s Whereabouts.”
The Whereabouts is software where riders are obliged to provide an address and one-hour time slot each day where they can be found by testers. If an athlete isn’t where they said they’d be three times in 12 months (down from 18 months, since 2015), that constitutes an anti-doping violation and could lead to a ban.
Many riders have missed a test, including Jonas Vingegaard in 2019.
“I left my cell phone in the kitchen and then our doorbell didn’t work,” he told Danish news outlet Ekstra Badet.
“They tried to call me and it was clear that it wasn’t possible to answer.”
Mark Cavendish also missed a test back in 2011. One missed test, of course, isn’t an admission of guilt – unless you later reveal how you can game the Whereabouts system.
Cross-country skier Max Hauke, who was caught up in the Aderlass scandal and was filmed infusing his own blood, would go on to tell an anti-doping conference that he chose to live in a top-floor flat so that if anti-doping officers rang, he’d have time to drink saltwater, which can mask the markers of doping.
He’d also tell the officials that he’d just trained hard, so they’d have to wait two hours, because exercise can distort the results.
The Spanish newspaper Marca uncovered further gaps in the Whereabouts system when investigating Operation Ilex, revealing that riders could be manipulating Spanish privacy laws, which state that doping controls at athletes’ homes between 11pm and 6am aren’t permitted. Visiting at weekends isn’t allowed, either, unless special permission is obtained from the authorities.
This buying of time is a technique used by Armstrong, who told American comedian Bill Maher: “When I pissed in the cup and they tested the piss in the cup, it passed. Now, the reality and the truth of all of this is [that] some of these substances, primarily the one that’s the most beneficial [which we all took to be EPO – ed], has a four-hour half-life… With a four-hour half-life you can just do the math.”
Location, labs and level
Marca also reported another area of concern for anti-doping authorities – that samples had to be sent within 48 hours of being taken for analysis.
This created issues for countries with limited access to accredited laboratories.
“Globally, there are only 30 WADA-accredited laboratories, so for most countries it’s a doping-testing freezone,” says Parisotto.
“These areas are only covered if the international federations and ITA themselves conduct testing there.”
This tallies with the Credibility Figures report from the MPCC (Movement for Credible Cycling), where, as of September 2024, “75 professional licence-holders had been suspended for an anti-doping rule violation (ADRV)… These suspensions are present in almost all cycling disciplines – road, track, cyclocross, BMX and mountain biking.”
Of these 75 suspended riders, Colombians topped the list, with 16 accused. Colombia doesn’t have a WADA-accredited lab. Its nearest is neighbour Brazil’s.
That said, the MPCC suggested it was team level rather than location that led to the positive tests: “Many of the riders who tested positive were semi-professional riders taking part in races on the American Continental calendar, races that aren’t subject to testing either by national agencies or by the UCI.”
Portugal was next at 15, many suspended after the Prova Limpa operation carried out by local police, after a whistleblower revealed the extent of drug-taking at the Continental W52-FC Porto team. Of third-place Italy’s eight riders, five raced at Continental level.
Why the disproportionate positives from Continental riders? Arguably, it’s due to the ABP not being mandatory for third-division riders.
You might think that if an illegal drug such as EPO has such an impact on performance, why are cheating Continental riders not strong enough for the ‘cleaner’ WorldTour level? Sceptics might suggest WorldTour athletes and teams have the resources to never be caught.
It’s a point Faiss counters: “Today, you’re able to detect substances with concentrations 1,000 times less than 10 years ago.”
To which Parisotto bats back: “Athletes will also seek to exploit loopholes in the regulation. The increased sensitivity of testing has created a greater likelihood of positive results from contaminated supplements or food.
“A drug detected in urine from contamination is impossible to differentiate from deliberate use just through testing, creating more scope for athletes to contest the results.”
Faiss and Parisotto agree that the anti-doping movement needs more funding, though. Testing is expensive. It’s why the aim of the ABP is an average three tests per year.
This season, men’s WorldTour teams contributed €215,000 to the ITA as part of their UCI registration, while men’s Pro teams gave €100,000. For many, this is less than 1% of their budget.
The UCI’s anti-doping contribution is €10 million, while further money comes from behemoth races such as the Tour de France ($214,000). WADA’s annual budget for sport is $57.5 million.
In the trillion-dollar sports industry, that’s pennies. So, why not more?
“I’d assume that every anti-doping organisation and sporting federation would regard a successful anti-doping programme as one that has uncovered few cheats, ensuring that their patrons, backers and sponsors keep ‘turning up and paying up’,” says Parisotto.
“For any sport, to expose widespread doping would be anathema to its image, and probably existence, so it cannot be too strong.
“You’ll note some cynicism here, but at best anti-doping worldwide efforts constitute a ‘limited hangout’ situation [where a small section of a scandal is made public, without telling the whole story – Ed], if not by design, then simply because of the lack of will and resources devoted to the matter.”
It’s sobering that exposure of the big doping scandals, such as Festina, Puerto and Aderlass, wasn't directly down to doping organisations, but to law enforcement.
The future
Where does that leave us? The ABP isn’t perfect but, says Faiss, it’s proved an effective deterrent.
He says there’s increased funding being directed at a host of anti-doping projects, such as the use of AI to identify anomalies in millions of data points.
As for Parisotto, he has a wealth of ideas to bolster the system, including extending the reach of the ABP programme via local accredited labs.
“Testing and results management should also be performed by external independent agencies,” he says.
“Trust in the system has been compromised of late and mandates that sporting federations must be more transparent with results management. I’d also make it a mandatory condition of athletes being allowed to participate in the sport that test results are publicly available.
“Ultimately, the temptation to dope comes down to risk and reward rather than a moral or ethical choice. Doping will always be part of sport, but every available resource should be made available and be undertaken in an environment free from personal, corporate, commercial and political interference.
“These are utopian and lofty ideals, but what’s the alternative? A drug free-for-all. And what about other forms of ‘doping’ – mechanical, bio-technological and genetic?
“At times the problems appear insurmountable, but to do nothing would be irresponsible and would foster a culture that ‘normal’ isn’t good enough.”
