The Chris Froome Ruling Just Broke Anti-Doping

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Let’s be clear: most sports contend with doping issues. But it’s professional cycling that seems to have made the biggest mess out of them. That’s (again) the situation for the sport with the news on Monday that Chris Froome is cleared in his doping case.

Part of the problem with this decision is the timing. After keeping the public in the dark for nine months, cycling’s international governing body, the UCI, announced five days before the start of the Tour de France that it was dropping Froome’s doping case over his “adverse analytical finding” for salbutamol at last September’s Vuelta España. That finding was kept secret until it leaked in December, and the case dragged on long enough that it overshadowed the Brit’s win in May’s Giro d’Italia. It threatened to do the same to the Tour and race organizers were prepared to try to stop him from entering. (The UCI addressed the timing of the announcement in a press release by saying, "Whilst the UCI would have obviously preferred the proceedings to have been finalised earlier in the season, it had to ensure that Mr Froome had a fair process, as it would have done with any other rider, and that the correct decision was issued….The UCI prepared and issued its formal reasoned decision as quickly as possible in the circumstances.")

But the timing isn’t my main problem with the ruling. Instead, it’s the substance of the decision, and the impact it may have on the Olympic sports world. In short, it threatens the stability of the entire anti-doping system.

First, some background. Froome is an asthmatic, and uses a salbutamol inhaler, as do a number of other cyclists. Under the World Anti-Doping Association (WADA) rules, the substance is legal for inhalation only (no pills allowed), but only up to a certain threshold, which is measured via metabolites in a urine test. Froome got into trouble at the Vuelta when an anti-doping test late in the race revealed he had twice the legal limit in his sample. From the beginning, Sky and Froome always maintained his innocence, and the team was quick to trumpet the UCI decision in a press release where Froome said, “I am very pleased that the UCI has exonerated me.”

According to those same WADA rules, when a sample exceeds the limit, it’s presumed that the athlete took more than the maximum allowed dose. In that instance, the athlete must undergo what’s called a “controlled pharmacokinetic” (PK) study to attempt to show that the elevated finding resulted from a legal dose. Essentially, it’s a single-subject excretion study where the athlete attempts to recreate the timing, total dosage, and number of doses from the day he tested positive. He then hopes that the result corroborates his initial test results.

But as WADA revealed in its press release affirming that it would not appeal the UCI’s decision, Froome never did the PK study because “it would not have been practicable as it would not have been possible to adequately recreate the unique circumstances that preceded the doping control.”

Instead, WADA and the UCI accepted other evidence Froome submitted that suggest his test result was within the permitted maximum dose. Essentially, Froome was allowed to successfully argue that it was likely he didn’t exceed the legal dose, even though he couldn’t prove it.

That is literally extraordinary.

The UCI did not detail (and apparently does not plan to detail) the evidence Froome submitted and what aspects were specific to his own physiology. (Reportedly, Froome submitted some 1,500 pages of evidence, among them a salbutamol review where the subjects of one study were dogs.) It doesn’t mention why Froome’s circumstances were somehow markedly different than other athletes—like Diego Ulissi—who were required to do the PK test. And WADA’s press release makes no mention of changes to future salbutamol testing.

So Froome’s case appears to be a massive departure from the process that every other salbutamol case in the last decade has gone through. And, based on evidence that the authorities won’t disclose, it is also apparently a unicorn: a one-off exception that doesn’t touch the foundations of the salbutamol test regime.

WADA has not known what to do with salbutamol since the organization was founded. The original WADA Prohibited List in 2004 banned salbutamol unless the athlete had a Therapeutic Use Exemption; even then there was a threshold beyond which a TUE didn’t apply. In 2010, they scrapped the TUE requirement but kept the threshold, essentially allowing any athlete to use salbutamol up to the that legal limit.

And while positive tests have been rare since 2010, the threshold has been challenged in academic research, which suggests that individuals can metabolize identical doses differently, and that criticized WADA for failing to account for factors like dehydration. Into all this comes the Froome ruling. You can bet that the next athlete to fall foul of the salbutamol threshold is going to reference the Froome case in his or her defense, both to get out of the PK study requirement and to attack the result itself as unreliable. They may even attempt to compel WADA to share the evidence Froome submitted.

More troubling, the Froome case sets up a blueprint for how to challenge any WADA test. Almost all of the substances on the WADA Prohibited List are detected with tests that have some kind of subjective interpretation. EPO, for instance, is detected using gel electrophoresis, which separates synthetic and naturally occurring EPO based on the size and charge of the metabolized protein molecules. To be declared positive, a certain percentage of the resulting isoforms have to appear in a certain range, and that range is down, somewhat, to interpretation. Biopassport testing is similarly down to expert interpretation of fluctuations in blood and hormone chemistry—patterns that vary not just because of doping, but benign factors like plane travel, racing and illness.

The Froome ruling now sets a precedent for future doping cases. If the protocol around the salbutamol test is wrong, or meldonium, to name a recent high-profile debacle, then it raises the question of whether other tests may be similarly flawed. And tests may not necessarily be protected by the fact of their establishment. In 2015, Irish track and field sprinter Steven Colvert was banned two years for EPO use despite questions over whether his sample met the criteria to be declared positive. A later report by Norwegian researchers further questioned whether the tests were reliable. Colvert didn’t pursue an appeal, at least in part because it was too expensive. But had Colvert had resources, a successful appeal might have upended the EPO urine test, despite having been in use for 15 years.

Ross Tucker, the author of the influential Science of Sport blog, tweeted:

https://twitter.com/Scienceofsport/status/1013725303670296576

Anti-doping authorities were never set up for expensive, protracted legal fights with deep-pocketed athletes. WADA’s annual budget for 2018 increased 8 percent, to $32 million. That sounds like a lot, but Froome alone makes a reported $5 million per year from his Sky contract (not including endorsements). He’s one of just a handful of pro cyclists who make enough for a high-dollar defense, but WADA oversees all Olympic sports, including those with athletes whose earnings dwarf Froome’s. Imagine if an athlete who makes tens of millions of dollars tests positive.

At the same time, WADA’s research budget has plummeted from almost $7 million a year in 2006 to $1.5 million in 2018. Those funds were gutted in part by expensive investigations like into state-sponsored Russian doping. But that research is also exactly the kind of thing they’ll need to defend—and improve—the testing standards.

The warning signs are already out there. Three years ago, the UCI pursued a biopassport case against cyclist Roman Kreuziger for nearly a year until dropping it literally on the eve of trial, citing “newly obtained evidence” that was never detailed. The UCI hasn’t successfully pursued a case since, although it just opened one against road cyclist Jaime Roson. Track and field hasn’t seen a successful passport sanction since September 2016.

Maybe the UCI has compelling, specific scientific evidence that supports the idea that Froome’s case is a one-off outlier and doesn’t affect the overall stability of the salbutamol testing regime. If so, they should detail it, and Froome should have no problem with that since it will help to bat down accusations of preferential treatment.

But if they don’t have that evidence and, instead, what Froome showed is simply that the test doesn’t work as well as WADA contends, then that’s extremely troubling. It’s not just about Froome, or salbutamol, or cycling. The entire structure of anti-doping rests on the presumption that the tests work as the authorities say they do, that the rules are the same for everyone, and that not only are cheating athletes caught, but more importantly that clean ones aren’t. If that’s not true?

Then WADA’s entire reason for existence is in doubt.