Performance enhancement is considered an essential part of sport.1 However, in the world of competitive and high-performance sports, there is increasing evidence of a high prevalence of performance-enhancing drug abuse.2, 3, 4 The use of drugs—that is, banned substances—has become a serious problem with significant social, ethical, policy, and personal consequences,5, 6, 7 and consequently compromises the integrity of sports and sportsmanship at all levels of competition, as well as the health and well-being of individual athletes and public health in general.
In the fight against the use of banned substances, over the past few decades there has been a strong anti-doping movement across sports organizations and authorities at the state level and among international sports federations such as the International Olympic Committee, which formed the World Anti-Doping Agency (WADA, https://www.wada-ama.org) in 1999. WADA's purpose is to promote and coordinate international efforts against doping in sport. Since its establishment, WADA has created a global rulebook containing the World Anti-Doping Code8 and, more recently, has developed a Whistleblowing Program (WP).9 As part of the WP, WADA has also launched a “Speak Up!” platform to encourage informants and whistleblowers to report doping violations.10
Although there are various mechanisms for making inquiries about or discovering illegal drug use in sports, such as oral and written evidence, academic research, and investigative journalism, encouraging individuals to report illegal drug use (in other words, to be a “doping whistleblower”) has received increased attention in research.11, 12 Whistleblowers have been increasingly important and impactful in exposing sports doping, with recent examples including Russian insiders whose allegations caused the nation to be banned from some sports at the 2016 Summer Olympics in Rio de Janeiro and from the entire 2018 Winter Olympic Games in Pyeongchang. Although the validity of the whistleblowing approach remains to be determined scientifically, the WP is significant in that it recognizes the importance of individual responsibility for creating and maintaining a zero-tolerance culture for doping,9 as well as providing a secure and confidential method for anyone who reports an activity that is in violation of WADA's anti-doping rules.
Four decades of economic reforms have significantly raised China's status and reputation related to its athletes’ performance in the world of sports. Landmark events, including the 2008 Summer Olympic Games in Beijing and the upcoming 2022 Winter Olympic Games, will distinguish China as the first country that will have hosted both the Summer and Winter Olympic Games in the current century. With China's increased reputation for sports excellence and as home to many top medal recipients in a number of world-class competitions, Chinese sport authorities and elite-level athletes face increasing pressure not only to win medals but also to ensure that athletic doping does not pose a significant threat to the credibility of Chinese sport.13 However, over the decades, some high-profile doping scandals have been reported across a range of sports (e.g., swimming, track and field) with athletes testing positive for steroids, ultimately leading to their medals being stripped.13, 14 It is likely that, as in many other countries, the use of doping substances among Chinese athletes remains of high ethical concern, and there may be unreported cases of doping that give rise to the need for implementing the WP in China.
Although China has anti-doping rules and regulations established by the country's Anti-Doping Agency,14 Chinese sport agencies have primarily relied on a detection–deterrence approach supported by precision laboratory testing. However, little has been done to establish reliable, nonanalytical, individual reporting mechanisms that are in line with the WP to ensure secure and nonrisk reporting. Thus far, the adoption of WP in China has been very limited in scope, and its future implementation will face several practical barriers and cultural challenges.
First, even though the reporting of drug use among athletes is encouraged in the Chinese anti-doping policy,15 it has not yet been recognized, either in practice or at the policy level, as one of the most important sources of information in identifying drug violations. Second, although there is a high risk of retaliation for being an informant or whistleblower, no protective measures have been created to encourage informants and whistleblowers to report suspected doping violations. Similarly, there are no explicit safety assurances protecting the identity of the whistleblowers to ensure their right to confidentiality as outlined in WADA's WP. Additionally, cultural conditions may prevent an informant from willingly coming forward when a doping issue or sports event does not involve a personal interest. Finally, there is no reward system to incentivize whistleblowers to speak up.
There are several practical solutions to these challenges, including the following.
Recognizing whistleblowers as an important element in the fight against doping in sport. As reflected in the publication of the WP,9 there is an increased recognition of the important role whistleblowing plays in soliciting reports of wrongdoing or exposing violations of the WADA Code.8 Accordingly, there is a policy need for the sports regulatory regime and anti-doping agencies at all levels to more explicitly integrate this element into their rules and norms governing doping in sports to strengthen compliance with WADA's WP.
Aligning current anti-doping policies with WADA's WP. The current anti-doping policies established by China's Anti-Doping Agency should align closely with WADA's WP, including essential elements of support, protection, and reward. The policy should be extended to specifically provide support to encourage and engage whistleblowers. In addition, a law is needed that protects whistleblowers’ anonymity, ensures the integrity of measures protecting them, and minimizes any risks (e.g., intimidation and harassment) they face related to the exposure of their identity to the public.
Developing a whistleblowing system. An online whistleblowing system or portal should be established, similar to the WADA model, that creates a reporting platform that enables individuals (athletes, coaches, medical professionals, and others) to make anonymous reports of any violation. Like the WADA “Speak Up!” platform, a system should be developed in China to facilitate whistleblower activities.
Educating athletes about whistleblowing. Research shows that although current anti-doping efforts encourage and rely on whistleblowing, many athletes are reluctant to become whistleblowers.12 Therefore, there is a need to create an education program that provides athletes at all levels with support for their whistleblowing actions to ensure that doping does not occur. The education program should not only include discussion of the significance, mechanisms, responsibilities, and psychological, social, and economic consequences of doping in sports but also should identify available means for reporting, potential risks of reporting (e.g., stress, intimidation), and measures in place to protect the integrity and identity of whistleblowers.
Changing the social stigma accompanying the reporting of doping through public campaigns. Because the harm created by doping in sports and sportsmanship is well known,16, 17, 18 there is a clear need to launch public information campaigns that raise societal awareness of the adverse effects of doping on sports. The goal of these campaigns should be to change the broader policymaking, group, and community perceptions and norms about whistleblowers as informants.19, 20
Because of the emphasis on the importance of superior performance at all costs among elite athletes and the increase in the use of performance-enhancing substances, it is time for sports governing bodies in China to move forward in developing anti-doping whistleblower policies that are based on the WP. Such policies would help manage and control the use of illegal substances in sports to protect the public interest and preserve the integrity of sports in China.
Competing interests
The author declares that he has no competing interests.
Footnotes
Peer review under responsibility of Shanghai University of Sport.
References
- 1.Kayser B, Smith A. Globalisation of anti-doping: the reverse side of the medal. BMJ. 2008;337:a584. doi: 10.1136/bmj.a584. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.de Hon O, Kuipers H, van Bottenburg M. Prevalence of doping use in elite sports: a review of numbers and methods. Sports Med. 2015;45:57–69. doi: 10.1007/s40279-014-0247-x. [DOI] [PubMed] [Google Scholar]
- 3.Ulrich R, Pope HG, Cléret L, Petróczi A, Nepusz T, Schaffer J. Doping in two elite athletics competitions assessed by randomized-response surveys. Sports Med. 2018;48:211–219. doi: 10.1007/s40279-017-0765-4. [DOI] [PubMed] [Google Scholar]
- 4.Dietz P, Ulrich R, Dalaker R, Striegel H, Franke AG, Lieb K. Associations between physical and cognitive doping—a cross-sectional study in 2,997 triathletes. PLoS One. 2013;8:e78702. doi: 10.1371/journal.pone.0078702. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Schneider AJ, Friedmann T. The problem of doping in sports. Adv Genet. 2006;51:1–9. doi: 10.1016/S0065-2660(06)51001-6. [DOI] [PubMed] [Google Scholar]
- 6.Ahmadi N, Ljungqvist A, Svedsäter G. Routledge; New York, NY: 2016. Doping and public health. [Google Scholar]
- 7.Negro M, Marzullo N, Caso F, Calanni L, D'Antona G. Opinion paper: scientific, philosophical and legal consideration of doping in sports. Eur J Appl Physiol. 2018;118:729–736. doi: 10.1007/s00421-018-3821-3. [DOI] [PubMed] [Google Scholar]
- 8.World Anti-Doping Agency. The World Anti-Doping Code. Available at: https://www.wada-ama.org/en/what-we-do/the-code; [accessed 06.06.2018].
- 9.World Anti-Doping Agency 05.06.2018. https://www.wada-ama.org/sites/default/files/whistleblowingprogram_policy_procedure_en.pdf WADA Whistleblowing Program: policy and procedure for reporting misconduct. Available at: [accessed 05.06.2018]
- 10.World Anti-Doping Agency 04.06.2018. https://speakup.wada-ama.org/FrontPages/Default.aspx Speak Up! Available at: . [accessed 04.06.2018]
- 11.Whitaker L, Backhouse SH, Long J. Reporting doping in sport: national level athletes' perceptions of their role in doping prevention. Scand J Med Sci Sports. 2014;25:e515–21. doi: 10.1111/sms.12222. [DOI] [PubMed] [Google Scholar]
- 12.Kelsey E, Susan B, David C. “I don't know if I would report them”: student-athletes' thoughts, feelings and anticipated behaviours on blowing the whistle on doping in sport. Psychol Sport Exerc. 2017;30:45–54. [Google Scholar]
- 13.Fan H, Lu Z. The politics of doping and anti-doping in Chinese sport. Int J Hist Sport. 2012;29:132–144. [Google Scholar]
- 14.China Anti-Doping Agency 06.06.2018. http://english.chinada.cn/u/cms/english_www/201711/01103213m8yb.pdf CHINADA annual report 2016. Available at: [accessed 06.06.2018]
- 15.China Anti-Doping Agency 06.06.2018; in Chinese]. http://english.chinada.cn/u/cms/www/201504/25214548k7he.pdf Anti-doping management regulation of China, 2015. Available at: . [accessed 06.06.2018]
- 16.Reardon CL, Creado S. Drug abuse in athletes. Subst Abuse Rehabil. 2014;5:95–105. doi: 10.2147/SAR.S53784. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 17.Creado S, Reardon CL. The sports psychiatrist and performance-enhancing drugs. Int Rev Psychiatr. 2016;28:564–571. doi: 10.1080/09540261.2016.1190690. [DOI] [PubMed] [Google Scholar]
- 18.U.S. Anti-Doing Agency 06.06.2018. https://www.usada.org/substances/effects-of-performance-enhancing-drugs/ Effects of performance-enhancing drugs. Available at: . [accessed 06.06.2018]
- 19.Grigore V, Stanescu M, Stoicescu M. Promoting ethics and integrity in sport: the Romanian experience in whistleblowing. RREM. 2018;10:84–94. [Google Scholar]
- 20.Whitaker L, Backhouse SH, Long J. Reporting doping in sport: national level athletes’ perceptions of their role in doping prevention. Scand J Med Sci Sports. 2014;13:e515–e521. doi: 10.1111/sms.12222. doi:10.1111/sms.12222 [DOI] [PubMed] [Google Scholar]