There is a great deal of information as well as misinformation about Rita Jeptoo’s case. Hopefully this article will shed a light on the issue and encourage positive debate.

Rita Jeptoo is a renowned Kenyan marathon runner whose sample tested positive for EPO – full name- erythropoietin  (pronounced eh-ri-thro-poy-tin) aprohibited substance on the IAAF prohibited list . The Adverse Analytical Finding (AAF) of her doping test is as a result of out-of-competition testing carried out on 25th September 2014  during her training for the Chicago marathon which was held on 12th October 2014(which she won).

Before we move on, you need to familiarise yourself with terms used in anti-doping. Here are a few, basic definitions of some key words:

• Anti-doping violation– circumstances or conduct which constitute a violation of  anti-doping rules. These include:  presence of a prohibited substance in an athlete’s sample; use or attempted use of a prohibited substance or method;  possession of a prohibited substance or method; administration or attempted administration to an athlete of a prohibited substance or method; refusing, evading  or failing to submit to sample collection; failure to file athlete whereabouts & missing doping tests; assisting, tampering or attempting to tamper with any part of the doping control process; and encouraging or covering up an anti-doping violation.
• Prohibited List– a list that identifies all the substances and methods that athletes are forbidden from using when participating in sport.
• Prohibited Substance-  a substance which is banned  from use in sports. This includes performance enhancing substances, masking agents (agents that hide the use of a banned substance), and substances which when used in training may have long-term performance enhancing effects. It is important to note that some substances are banned at all times (both out-of competition & in-competition) while others are only banned in-competition e.g.  use of anabolics such as steroids are banned at all times  whereasstimulants are banned in competition only. There are also some substances which are banned only in particular sports- for examplealcohol is banned in motor-sports, aviation sports, sailing, & precision sports such as shooting and archery; and the use of beta-blockers is banned in precision sports.
• In-competition testing– testing done during an event commencing 12 hours before an athlete is scheduled to participate up until the end of the competition.
• Out-of-competition testing– any testing done at any time and at any place outside of an event.
• Adverse Analytical Finding– a report from a laboratory approved by the World Anti-Doping Agency (WADA)- identifying presence of a prohibited substance or its traces in an athlete’s sample.

What is EPO?

EPO is classified as a prohibited substance under S2. of the WADA Prohibited List-  Peptide hormones, Growth Factors and Related Substances.

It is a hormone produced by the kidney that promotes the formation of red blood cells by the bone marrow and initiates the synthesis of haemoglobin (the molecule within red blood cells that transports oxygen). Pharmaceutical EPO stimulates the bone marrow to produce more red blood cells. Stimulating agents can be given in two ways; they can either be injected into a vein with an intravenous (IV) needle or injected under the skin (subcutaneous).

The resulting rise in red cells increases the oxygen-carrying capacity of  blood. Medically, it can be used as a treatment of some forms of anaemia but it has been misused as a performance-enhancing drug by some athletes in the past, so it would be difficult for doctors to prescribe such treatment for active athletes.

Read more about EPO on these links: medicine.net, WebMD, and rice.edu.

The nature of a banned substance at the center of an anti-doping violation is important because it points towards certain key considerations. Its uses, effects, and manner by which it enters the body are all important factors when determining degree of fault of the athlete and  sanctions to be applied. We shall re-visit this later.

Why was Jeptoo tested out-of-competition and why is this significant?

As an international elite athlete participating in some of the world’s greatest races, Jeptoo is subject to doping tests to ensure sporting integrity and is therefore included in the Registered Testing Pool (RTP). An athlete receives written notification when he/she is listed in the Registered Testing Pool and must submit his/her whereabouts.

• Registered Testing Pool (RTP)– list of top-level athletes subject to both in-competition and out-of-competition testing.
• Whereabouts Information– information  required from an athlete identified in an RTP. Usually includes an athlete’s location over a period of every 3 months and  details such as the athlete’s home address, training venues & schedules, competition schedules, and regular activities such as work & school. Athletes must make themselves available at a given time and place, seven days a week- failure to do so would amount to an anti-doping violation. Whereabouts are filed through ADAMS (Anti-Doping Administration & Management Systmem)- an online data-base for entering, storing, reporting and sharing anti-doping data.

Submission of an athlete’s whereabouts is necessary so that doping control officers can find athletes when carrying out no notice controls (doping tests with no advance warning to the athlete). Controls are made at times when athletes might benefit from taking prohibited substances. These are usually out-of-competition periods when prohibited substances can still be traced (the detection window).

Samples are collected and divided into 2 bottles, A & B, which are then sealed and packaged for shipping to a WADA accredited laboratory. The athlete also fills out a Doping Control Form which includes a declaration of any prescription, non-prescription medication or supplements that the athlete may have taken recently.

Jeptoo is at the top of the leaderboards of the World Marathon Majors (WMM)  series  with 100 points after winning the Boston and Chicago Marathons in both 2013 and 2014. This means that she was going to be the recipient of the WMM Series title together with a huge award of $ 500,000 US dollars. There was clearly a lot at stake for her.

As a side note- the marathons on the WMM circuit are- Tokyo, London, Boston, Berlin, Chicago, New-York,  the Olympic Marathon and IAAF World Championships Marathon. Winners of each leg are awarded with a maximum of 25 points. To read more about how the WMM works and its ranking system clickhere.

What happens after an Adverse Analytical Finding (AAF)  is made?

WADA, IAAF, and the athlete’s national federation will be informed of the results simultaneously.

If there is an AAF on the athlete’s A sample the anti-doping organization responsible for results management conducts an initial review to verify if the athlete had a Therapeutic Use Exemption (TUE) for the prohibited substance found in the sample. They also verify that sample collection and analysis was carried out according to International Standards set out by WADA.

• Therapeutic Use Exemption– permission granted  by an anti-doping organisation to an athlete with a documented medical condition to use a prohibited substance or method over a specific period of time. Applications for TUE should be made as soon as possible i.e. when the athlete is first notified of his/her inclusion in the RTP but no later than 30 days before the athlete’s participation in an event (except for emergency situations).

If there was no TUE and no procedural anomalies during sample collection and analysis then the athlete is notified in writing of the results as well as his/her rights regarding analysis of their B sample.

A positive test  automatically leads to suspension from further competition and disqualification of any competition results from events entered any time after the positive sample was taken. Results and medals from before the time the positive sample was provided will not be disqualified/ removed.

Jeptoo now has the opportunity to have her B sample tested. If her B sample  analysis is negative/ does not confirm the A sample analysis then the test result will be invalidated, no further action will be taken, and the provisional suspension will be lifted.

What happens if results of the B sample confirms those of the A sample?

Jeptoo will have the right to a fair hearing to determine whether an anti-doping violation has occurred and what sanctions will be imposed. I must point out the Strict Liability Principle in anti-doping matters.

• Strict Liability Principle–  An athlete is responsible at all times for whatever enters his/her body. An anti-doping violation occurs whether or not the athlete intentionally or unintentionally used a prohibited substance. Athletes are supposed to diligently inspect and check everything that enters their body. Even over-the-counter drugs might contain prohibited substances so it is the duty of the athlete to read the label and counter-check if the pharmaceutical product might contain substances on the prohibited list.

According to the strict liability principle it is not necessary that intent, fault, negligence, or knowing use be demonstrated in order to establish an anti-doping violation. There is absolutely no presumption of innocence in the fight against doping.

The athlete must show how the prohibited substance entered his/her body. He/she therefore has a possibility to avoid or reduce sanctions if it is demonstrated that he/she bears no fault or bears no significant fault or negligence in how the substance entered the body. This is a difficult standard to prove. Usually, only athletes who had absolutely no clue that they were being doped can achieve this.

Remember I mentioned about the importance of the nature of the prohibited substance in question… If the substance is one that is to be ingested in order to enter the body, then perhaps an issue of sabotage or secret doping by a member of the athlete’s support team is a possibility. However, if the prohibited substance is one that needs to be injected into the body it is more difficult  to prove no significant fault or negligence.

Sanctions may also be eliminated or reduced in cases where the athlete proves that the substance in question is a Specified Substance and was not intended to enhance his/her performance. This can be done if the following circumstances are proven to the Comfortable Satisfaction of the hearing panel: the nature of the substance or the timing of its ingestion would not have been beneficial to the athlete, the athlete openly used or declared the use of the substance on the Doping Control Form, and the athlete provided corroborating evidence in form of medical records supporting the non-sport-related prescription of the Specified Substance.

• Specified Substance- a substance that appears on the Prohibited List that has a great likelihood of a credible, non-doping explanation. This is especially useful when establishing the degree of fault of the person found to be in violation of an anti-doping rule
• Comfortable Satisfaction of a hearing panel- Since doping is a quasi-criminal offence the standard of proof required to prove no significant fault or negligence is higher than that of a balance of probabilitybut lower than beyond a reasonable doubt.

Unfortunately, EPO is not categorised as a Specified Substance which means that Jeptoo might face a minimum sanction of 2 year ineligibility period for the presence of a Prohibited Substance. She also faces disqualification of results of any events following the date of the anti-doping rule violation – this includes the recalling of the 1st place medal at the Chicago Marathon, deduction of ranking points, and forfeiture of the WMM title and prizes.

Is there a right to Appeal a sanction?

Yes, an athlete has the right to appeal the decision in a doping case and to have the case heard by an independent body such as the Court of Arbitration for Sport (CAS).

It will be interesting to see how this case unfolds- the arguments brought forward by Jeptoo, the reaction of her management and Athletic Kenya’s response to the situation. In the meantime, you may want to look at some of the IAAF anti-doping regulations and the WADA Code for a deeper analysis of the anti-doping rules and regulations.