Intended for healthcare professionals


Globalisation of anti-doping: the reverse side of the medal

BMJ 2008; 337 doi: (Published 04 July 2008) Cite this as: BMJ 2008;337:a584
  1. Bengt Kayser, professor and director of the institute of movement sciences and sports medicine1,
  2. Aaron C T Smith, professor and director of sport and leisure management2
  1. 1University of Geneva, 1211 Geneva 4, Switzerland
  2. 2Faculty of Law and Management, La Trobe University, Melbourne, Australia
  1. Correspondence to: B Kayser bengt.kayser{at}
  • Accepted 19 June 2008

Current anti-doping policy is sufficiently problematic to call for debate and change, say Bengt Kayser and Aaron C T Smith

Performance enhancement has always been an essential part of sport, but over the past few decades a strong movement against doping has emerged, in parallel with the rapid development of biomedical technology. This movement was led by the International Olympic Committee, which in 1999 formed the World Anti-Doping Agency (WADA). WADA now leads a global movement for harmonisation of anti-doping rules in elite sport, using repressive, punitive policies for transgression, and documented within the World Anti-doping Code and an annually updated list of forbidden substances and methods (www.wada-ama-org).

Solicited by WADA, Unesco has proposed a convention against doping for signature by member states, adding to the pressure placed on national governments and sports federations to comply.1 This globalisation and harmonisation of anti-doping efforts is ostensibly reasonable since it is designed to enforce consistent rules throughout the elite sporting world. However, there are several compelling reasons to question current anti-doping policies. Inherent flaws and contradictions in the logic of anti-doping policy may have serious consequences for the health and wellbeing of athletes and for public health in general. This article summarises the problems of current anti-doping policy in accordance with the following postulates.


  • The reasons advanced for anti-doping policy are flawed and do not warrant strong punishment and costly repression of doping practices;

  • The effects of prohibition as a means for regulating doping behaviour remain unclear, so the emphasis should be on developing an evidence base regarding any detrimental effects of performance enhancement technologies in order to dissuade potential users rather than coerce them, and to ensure that anti-doping policy does not induce more harm in society than it prevents;

  • Testing for doping in bodily specimens will never uncover all …

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