After Valieva: 5 questions for a doping expert about fixing a messy system

The machinery of international sport generated an extraordinary and painful spectacle in women's figure skating at the Beijing Olympics, as young athletes tried to summon the performance of their lives without knowing all their rivals were clean. They did so with the knowledge that no medal ceremony would be held if the favorite, Kamila Valieva, reached the podium.

Then the Russian teenager's routine unraveled, and she collapsed into tears at the rink she once seemed destined to dominate.

"That was an incredibly troubling outcome," said doping expert April Henning, of the University of Stirling in Scotland. "A 15-year-old child under that kind of stress and scrutiny should not have been on the ice. At some point, athlete well-being must be the main concern — especially when the athlete is a minor."

Just 10 days earlier, Valieva had affirmed her status as a generational talent by becoming the first woman to land a quad jump in Olympic competition. Then word emerged that she had tested positive for trimetazidine, a heart drug banned by the World Anti-Doping Agency. Inexplicably, the sample dated from December — a result that should have barred Valieva from going to the Olympics. The case was further complicated by her status as a minor.

The Court of Arbitration for Sport allowed Valieva to participate in the competition, pending the results of an investigation.

"Regardless of the outcome of the doping investigation or the CAS decision that said she could compete, Valieva was failed at all levels in terms of duty of care," Henning said.

Valieva's case has triggered many questions about her coaches and other adults around her. It also threatens to undermine the legitimacy of the Olympics' touted ideals of fair play, and the effectiveness of drug policies that aim to prevent cheating.

"Anti-doping is a mess," said Henning, who is a director of the International Network of Doping Researchers. She co-authored a book, Doping: A Sporting History, which is due to come out later this year. We asked Henning about Valieva's case, and how anti-doping efforts might be improved.

Note: This interview has been edited and condensed.

Are doping risks greater for young athletes like Kamila Valieva?

Yes. Part of the controversy around Valieva is that she is considered a protected person under the World Anti-Doping Code. As we've seen in other sports, young athletes are vulnerable to abuse of various kinds due to the power imbalance between a young athlete and coaches, managers, federations, even parents.

We also understand that minors may not be able to make decisions in the ways we would expect adults to do so.

Strict liability is the bedrock of the WADA Code, as it is thought to prevent athletes from inventing justifications for how a substance ended up in their sample. But Valieva's minor status makes this difficult, as minors, in the worst case, might be forced or coerced into using something they either don't want to use, may not understand, or may even be unaware they are taking.

Even if they are willing participants in using a banned substance, we must question if a 15-year-old child is able to consent, particularly in such a high-pressured environment as elite sport.

Is the anti-doping system for big events such as the Olympics broken, as many suggest?

What's clear is that the current system is flawed. One of the clearest of these flaws is the absence of athletes' voices in the rule-making process. Yes, they are nominally included, and anyone can give input when WADA opens up for public comment, but it's clear the power lies with a handful of executives.

Advocacy groups like Global Athlete have been clear that athletes need and want a voice and that governance reform is required, but reforms have been slow and small-scale.

We do have other models for anti-doping policy making, such as North American professional leagues that collectively bargain their substance use policies. These diverge from Olympic/WADA governed sports and are sometimes viewed as being watered down, but they have athlete buy-in.

There are a host of suggestions for reform, from calls for criminalization of doping, to calls for liberalization of anti-doping rules, to the few who call for no anti-doping efforts at all.

Could better testing be an answer to the problem?

There are lots of incredibly effective tests, but analysis can only be done if samples are collected. If the collection is ineffective — or in many instances, absent as per WADA's published statistics — it doesn't really matter how sensitive the tests are.

But that needs to be balanced against athlete rights and practical matters like cost and logistics. There are no easy answers, but without willingness to understand why the current system is getting it so wrong, it seems unlikely that more of the same is going to improve the situation across sport.

Russia makes the most headlines for its doping — but how widespread is it?

If we look to estimates from researchers using various survey and modeling methods, this could be anywhere from 3% to 40% or more of athletes, depending on the sport and method used for the estimate. In other words, we don't know for sure.

If we learned two things from Russia it's that, first, large-scale systematic doping is indeed possible. Second, the best systematic doping program is the one we don't know about yet.

Before this figure skating scandal, many of us had never heard of trimetazidine. Have you seen doping strategies shift away from steroids?

Possibly, though much is likely sport-specific. Anabolic agents [such as steroids] are still a widely detected category of doping substance in sports where power and strength are beneficial.

Surely some substances come and go in popularity, but one real lack in our understanding of these patterns is that our evidence often comes only from reported anti-doping rule violations, which most researchers agree are a gross underestimation of prohibited substance use across sport.

But prevalence of substance use is difficult to study, as the stigma of admitting use is so great that there is no incentive for athletes to disclose use even long after they would be past the statute of limitations for any punishment.

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