Doping in Sport: The Future Looks Dismal

By David Walsh

SHORTLY before the Italian team departed their home country for the Olympic Games at Sydney, each of the 538 competitors had to submit blood and urine samples. The athletes believed they were tested for the usual substances. They should have known better.

Head of research at the Italian Olympic Committee (CONI), Professor Alessandro Donati has never played the doping game by the book: Donati knows the book is corrupt. Although there is no approved test for the detection of Human Growth Hormone (hGH) abuse, it is not difficult to establish the probability of misuse. Donati told his doctors to look for it.

Sixty-one Italian athletes had suspiciously high levels of hGH and, looking through the names, Donati knew who were likely to do well in Sydney. Five of those with enhanced levels of the hormone won gold
medals and, from his apartment in downtown Rome, Donati watched the nightmare unfold. As his compatriots rejoiced, he lay awake in bed.

What should he do? Without an accepted test for hGH, he couldn't prove anything. Yet it was cheating. It is a dilemma that sports doctors and officials have faced frequently over the past 20 years, and the general response has been to ignore it. Not Donati. His findings were leaked to an Italian newspaper. Five of Italy's 13 gold medalists were tainted and the world understood a little more about sport's great sickness.

Last November a Danish sports journalist, Jens Sejer
Andersen, stood before a group of international colleagues in Copenhagen and told them the news. "Sandro Donati," he said, "will not be coming to our conference. The Italian Olympic Committee, for
whom he works, do not want him to speak." Organizer of a five-day conference on world sport, Andersen's disappointment was palpable.

What had Donati done to merit being silenced?

The Italian has dedicated the past 20 years of his life to the cause of cleaner and fairer sport. His achievements have been considerable. In 1985 he persuaded the Italian government to ban blood doping, which prompted the International Olympic Committee (IOC) to do the same. Two years later, he uncovered corruption at the world track and field championships in Rome when the organizers faked a jump so that an
Italian, Giovanni Evangelisti, won a bronze medal.

In 1994, Donati researched the abuse of erythropoietin (EPO) in professional cycling and wrote a damning report. Cycling, he showed, was doped to the core. In 1998,, Donati was a key figure in the investigation that led to the closure of the IOC-accredited laboratory in Rome. The Rome lab had been falsifying tests on leading Italian soccer players, ensuring there would be no positive results.

Following Donati's work, prosecutors in Turin, Bologna, Ferrara, Venice, Rome and Brescia launched doping inquiries in their cities. Doctors, dealers and traffickers will go to prison.

Italy is not much different from the rest of the sporting world. But because of Donati, Italians know of the cheating that poisons modern sport. Officially denounced in his own land, unheard in other countries,
Donati is a lone voice in the stadium.

Sport is losing the battle against doping. Consider what was regarded as the greatest victory over doping, the police raids on the 1998 Tour de France. In the two and a half years since, nothing has changed. The
same officials still run the sport, the same doping still ruins it.

But, up to a point, sport has been getting away with it. Sydney's more earnest drug-testing ensured a slowing-down of the madness, but it will accelerate again. Tomorrow's doping will be more destructive and
far more difficult to detect than anything we have previously seen. It is not far-fetched to believe that genetically engineered athletes will mount the Olympic podium in Athens, less than four years from now.

Speaking at the Copenhagen conference, Professor Bengt Saltin outlined the research that has already been done in the area of gene therapy. The Swedish exercise physiologist quoted from a study in which a gene had been taken from a fly, modified and re-inserted. In
line with the purpose of the experiment, the strength of the fly's flight muscles were increased by 300%.

Gene therapy will bring with it enormous benefits for conventional medicine. Artificial genes will be able to kill or weaken cancerous cells, and will enable the body to produce its own drugs. They will be used to replace defective genes. Used improperly, however, they will destroy sport. A member of the medical committee of the World Anti Doping Agency (WADA), Saltin knows that sport now teeters close to the edge.

The medical technology to create the most pernicious form of doping will be available within five years, and if the past 20 years have proved anything, it is that unscrupulous medical practitioners will be prepared to use it.

"I began in medicine when I was 20," said Saltin, "and for 30 years I never came across a haematocrit level (percentage of oxygen-carrying red cells) greater than 45-46%, the average being 42- 43%. Then in the late 80s, the haematocrit levels of endurance athletes began to rise, up to 50% and over. This was not done by nutrition or training, this was EPO.

"The difference to performance was huge. Look at it this way: the haemoglobin or red cells carry oxygen from the lungs to the contracting muscles and each litre of blood has a given amount of haemoglobin. The normal upper limit is 145 grams per litre. That can
carry approximately 200ml of oxygen per litre of blood. That is the upper value, you cannot change it. With EPO you can get the haemoglobin level up from 145 grams per litre to around 200, and suddenly you are carrying 30% more oxygen in your blood."

Professor Saltin has worked with world-class endurance athletes over the past decade and has known the result long before the competition: "You work with a team that is not manipulating their blood, their haematocrit levels are a normal 42-43% and you know they will not be able to compete in major championships. You almost want to say, 'Don't even bother going'."

Saltin has been alarmed by the willingness of his colleagues in the medical profession to use the drugs for purposes that were never intended. "I find it totally depressing," he said. "Too little is done to
eliminate these physicians from sport, and we must now prepare for gene therapy, because there are doctors who will use it on athletes. Once the genes are commercially available, inserting them into the body will be simple."

The question is not whether sport can maintain its integrity in an uncertain future but whether, in fact, sport has a future at all.

ANGERED by the attitude of the CONI to Sandro Donati's
participation in his conference, Andersen turned up the heat on the Italian committee. Aidan White, the chief executive of the International Federation of Journalists, wrote a letter of protest to the Italians and, fearing a backlash, the Italians relented.

aThus it was that Donati began to tell his story. He was a young athletics coach in the Italy of the early eighties; first with the country's 400m runners and shortly afterwards with its 800m and 1,500m athletes. Donati was a clever coach and had many training ideas that would help athletes to improve.

But what did it matter how he coached? In the University of Ferrara in northern Italy, Professor Francesco Conconi worked on a program of blood transfusions that would change the face of Italian athletics. Conconi had the backing of the Italian Olympic Committee and most of the national sports federations. He was also supported by the late Primo Nebiolo, who was then the country's most influential sports administrator.

Even though it was not banned at the time, Donati saw Conconi's program as doping and campaigned to end it. Donati also believed the sudden death of the young middle-distance runner, Fulvio Costa, might have been caused by blood doping. But, by now, Conconi's program was beginning to yield results: Alberto Cova won the
10,000m and Gabriella Doria won the women's 1,500m at the Los Angeles Olympics.

Donati succeeded in getting the Italian government to outlaw blood doping and by now, he was a known opponent of Conconi's methods. Because Conconi's athletes were successful, very few paid attention to
Donati. Everything was denied, the Italian Athletics Federation dismissed Donati as a national coach and he was generally marginalized.

Then, at those 1987 World Athletics Championships in Rome, Donati discovered the video evidence that proved Italian officials had manipulated the results of the men's long jump to ensure Evangelisti would win bronze. Following Donati's detective work, the International Amateur Athletics Federation (IAAF) insisted Evangelisti hand back his medal.

But the greater problem was doping and, in 1989, Donati wrote a book, "Campioni Senza Valore" (Worthless Champions), detailing his nine-year struggle against the problem. During the first week, the book sold extremely well and then it disappeared. The publisher would not print any more and bookshops could not explain where it had gone. Donati later learned that the hand of Nebiolo lay behind its disappearance from the bookshelves.

One of the biggest difficulties of Donati's situation was that he worked for the CONI while knowing that the organization supported Conconi's blood doping. But that didn't deter him. In 1994, Donati tracked 12 key
players in the world of professional cycling and, in return for promising them anonymity, convinced his informants to speak honestly about doping.

Donati wrote a 14-page report which detailed the pervasiveness of doping in cycling and showed that Conconi had pioneered the use of EPO amongst elite sportspeople in Italy. Donati also showed that the
CONI had funded Conconi to dope athletes of various Italian teams. The report was submitted to the President of the CONI, Mario Pescante. He buried it. Pescante is still a member of the IOC and Conconi is still on that body's medical commission.

Two years after he had given his report to Pescante, Donati managed to get it into the public domain. All hell broke loose and, at last, the police and the Italian judicial system became involved.

The official sports world made one last desperate attempt to silence Donati when it sabotaged the urine sample of his athlete, the hurdler Anna Maria di Terlizzi, and spiked it with excessive amounts of
caffeine. The positive result was publicized and it was written that the great campaigner Donati was himself a doper.

At the obligatory testing of Di Terlizzi's B-sample, the fraud was uncovered and the head of the Rome laboratory was sacked. A year later, the laboratory was closed down. Donati continued the fight and he has been a key figure for the police in their six doping
investigations.

Conconi and his medical collaborator at the University of Ferrara have been indicted on charges of criminal association and are expected to stand trial in the autumn of 2001. Many other indictments are anticipated and, according to Donati, Italy will be a tougher country for those who wish to dope in the future.

From the outside, Donati's achievement are clear and significant. He feels no joy and no sense of vindication. His career as a coach was taken away but, greater than that, he feels the desecration of the love
he once felt for sport.

Recently, we spoke about his 20-year struggle when
Donati remarked that his father has understood what it had all been about. "He is a small peasant from the Frascati region, outside Rome. He is now 79, he still works every day and when I go to see him he asks me, 'What is all this stuff about doping?' What has it all been about? In the end, I can see schools putting children on their guard against certain sports, and you guys, the journalists, you will be writing about
gladiators, not sportsmen."

Donati is tired of the fight. He talks enthusiastically about working with those suffering from motor neuron disease. In this field, at last, his understanding of exercise physiology will be put to worthwhile use.

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