94 - Advances and Innovation from the Center for Research & Expertise in Anti-Doping sciences - Raphaël Faiss, PhD

Hi everyone and welcome to the Anti-Doping Podcast brought to you by the Partnership for Kling Competition. I'm your host Dr. Marie McNally and today we are joined by our expert guest Dr. Rafael Fice. listeners Rafael is research manager at the Center for Research and Expertise in Anti-Doping Sciences also known as Reds and also a senior lecturer in exercise physiology at the University of LaSonne. He's also a former elite cyclist and today Rafael is going to tell us more about Reds, Anti-Doping Research and some of his current research projects so Rafael we are excited to welcome you to the show today. How are you? Yeah I'm good thank you I'm happy to join and to explain a bit what we are doing here in Luzant for the Anti-Doping Research. Wonderful Rafael we are looking forward to learning from you today so can you start by telling us a little bit more about the Red Center at the University of LaSonne and what you do is research manager there. The Reds is a center of research and expertise in Anti-Doping Sciences. It was founded and started seven years ago and now we've built up a great network of research associate all over the world I would say with people working in labs with people working in national anti-Doping organizations and international federations to try to set up interesting and innovative research to bring the fight against the open a bit forward. Oh wonderful and what do you do there in your role as research manager? So as we are based at the University of Luzant it's true that the Reds is an academic entity so we need to focus a bit on research but also on education for the other hand that means that we strive to get that education part to raise the bar in terms of the knowledge in Anti-Doping not only for the athletes I would say where the education is mostly made by the NATO's or the international federations but to try to help engage people that are working already in Anti-Doping and to have them improve their abilities and try to set up also education programs that will make them more proficient and more efficient in the way they are dealing with anti-Doping in their sport. Interesting and of course separately I mentioned in our introduction you have this other education role as a senior lecturer in exercise physiology at the University of Luzant so can you tell us a little bit more about this role and maybe how it fits in with your roles and responsibilities as the Reds Research Manager? Yeah I think it's very interesting because at the beginning when I started working on Anti-Doping seven years ago I was a little bit afraid that I would not actually master all detection and science part that was happening in the Anti-Doping laboratories with my background as a exercise physiologist but then I noticed that people were really experts in the field in operations in the federations they were really experts in the analysis and detection part in the labs but bridging the gap between the knowledge that you have on how to perform on the field and how to analyze the right sample from the right attitude, the right moment is something where exercise physiology is highly needed to try to better understand how we can do this risk assessment in each sport based on the science and the science of the performance that is on the line. Fantastic and we mentioned you're at the University of Luzant and some of our listeners may know there's also a water accredited Swiss Anti-Doping lab in Luzant so Raphael can you tell us a little bit more about what the relationship is between the Swiss Anti-Doping Lab and the Red Center and how the two organizations interact. Yeah we are actually only a few kilometers away from the Swiss Laboratory for Anti-Doping Analysis and we do have a great collaboration with them. It must be said that the Reds was founded actually to separate some of the research activities from the lab activities because the lab in Luzant is a water accredited laboratory which means that they perform accredited analysis and when you do wish to do research with elite athletes sometimes it's difficult to access research protocols study design and the samples from athletes in the field that are not emerging only from doping controls and that is for the part a little bit of challenge but it's also an opportunity to set up and develop new research projects that are separate from the laboratory and then you can also understand that general people would certainly feel that there might be some kind of a conflict of interest when you are gathering or you are getting some research grants from International Federation's let's say for example the FIFA and at the same time you have the samples from the World Cup that are coming for analysis in the laboratory so having a separate entity to perform anti-doping research at the university while there is a good collaboration but independent collaboration with the Anti-Doping Laboratory is a way to make the research more transparent and to see where the firms go in terms of research for one part and in terms of analysis on the other hand. Absolutely and I think kind of gives you a little bit more flexibility because you're not trying to balance all the routine work as you highlighted there with trying to make progress in research I think that is a difficult balance for these water accredited laboratories to maintain. Yeah I think they do have to develop research in the labs but it's more oriented towards improving the analytical methods and at the university we can have maybe a little more holistic approach where we tend to understand how the performance production is actually affecting or is altering maybe the samples or the matrices that are collected for anti-doping and this definitely helps to design and set up the right strategies for the anti-doping operations to be more efficient on the field with evidence-based research that is done behind. Certainly and you hinted at this a little bit but anti-doping research is being conducted and supported by a lot of different entities internationally which is amazing so to help our listeners maybe appreciate or conceptualize this big picture Raphael can you break it down a little bit in terms of how anti-doping research is organized more broadly and some of these different stakeholders who are involved in it. So it's true when I'm asked about how the anti-doping world or the whole conception of anti-doping is done globally I break it down in three parts. On the first part you have the regulation you have the rules that you have to play with and this is made by the board anti-doping agency that sets the rule also based on the UNESCO convention for anti-doping and then you have the operations so based on the rules you have to have some kind of a referee or some entity that is trying to make sure that the athletes are playing by the rules and in the middle you then have the national anti-doping organizations that do strive to make sure that the athletes from a certain country will play by the right rules and also the international federations for them it's more difficult because they have to be in different countries where the competitions are and that can be all around the world or in specific countries for certain sports but in the operations you have these people from the natives and the international federations and the last part is actually the sanctioning part where you have the court of arbitration of sports there is also based in La-Zam that make sure that you have a fair process of the results management that is done beforehand to ensure that the athletes that do break the rule are getting sanctioned in a new right way and that the process is fully compliant also with rules so it's some kind of a circuit because you have the water setting rules you have the national anti-doping organizations and all the regional anti-doping organizations with the international federations that played role of the operators for collecting samples and analyzing so in that middle you also have the laboratories that are the key for the detection that is still a big pillar for the anti-doping and at the end of the group you have this court of arbitration of sports that make sure that the rules apply the right way and that all the athletes get a fair process of the results in case they would potentially break the rules. Absolutely and Rafael you mentioned the court of arbitration for sport is also in La-Zam as are some other key organizations that I think La-Zam as a city just has this rich history in anti-doping so does this impact or maybe even add an element to the work that you do just kind of being in this hub of sport and anti-doping. We are lucky here in Switzerland to be a bit in the center of this sporting world with more than 55 international sporting federations that are based in La-Zam or close to La-Zam this is also had by the fact that the IOC is also based in La-Zam and in the end the court of arbitration of sports makes it easy than to have this network built with the people that we can meet on a weekly basis that are only a few kilometers away where you can share the ideas the projects but also the latest news that are maybe too sensitive to be shared by email or by phone meeting the people is keep monitoring in developing the right tools for anti-doping because it's the way that we can make sure that you have a telemed program for the sporting federations but also the national anti-doping organization so luckily we have this European headquarters for the World Anti-Doping Organization agency that is in La-Zam we do also host at the University of La-Zam each year the workshop of the INADO the Institute of National Anti-Doping Organizations and that helps us also put together more than 200 delegates to discuss our topics in anti-doping and try to build up this network to share the knowledge and make sure that each one in each country will benefit from the latest knowledge in terms of science but also in terms of practical organizations of anti-doping in more experienced countries I would say awesome and I can see that it would be really exciting to be in a place where people are gathering and having these conversations about anti-doping and I think anti-doping is a really dynamic and exciting field to be in but I'm curious Rafael how did you initially get interested in anti-doping science and anti-doping research so it's true that I have been for a few years in each cyclist I could say semi-professional because you are professional in where you are citing a lot but you are not earning any money After that, the government had a chance to do a lot of research protocols for a friend doing a PhD as a University of Lausanne. And that's where I could get the chance to meet my PhD supervisor and do my PhD on hypoxic training. So altitude training and all the methods that you apply to try to improve performance naturally with the use of hypoxia as an additional stressor. And after that, I could work for two years at the Swiss Federal Office of Sport, developing all the scientific support for the Swiss cycling national teams. And that was fascinating to see all the details that you can put in the preparation for Olympics and trying to design the best tracks through to testing the aerodynamics of the wheels and so on. So all the details that are done by the athletes is a small part of the overall performance. And you see and you are in daily contact with these elite, that is this professional athletes that do work and try to do their best to perform at the highest level. And there you see that they have to comply with the anti-doping rules. And it was a way for me to enter the open world just to try to work for these athletes that are working really hard and that I supply examples to the anti-doping system where we know that the majority of the athletes are not doping hopefully. But that's based on also the performance studies that we have done. You see that the vast majority of athletes provide samples on a daily weekly monthly basis while only a tiny part are actually would actually be needed to track the cheese. That was interesting for me to enter that world and to try to develop the science or scientific project behind to help the entire athletes to do the work in the best way and show them that the scientific support was also there to make sure that we were doing our best to find the cheese. Absolutely. And I think having been an elite athlete yourself, it sounds like you can really empathize with this athlete journey and just the struggles that they go through and the importance of having this level playing field in clean sport out there. And I'm very curious to hear a little bit more about the work that you're doing at Reds. Now, so can you tell us, Rafael, what is the scope of, I guess, the different kinds of research that Reds conducts? So when we're thinking about the research we are doing at the Reds, we need to think about the environment that we have and the people, the resources that we have at Reds. And we are exercise physiologists for the most, but we also do have our director, Professor Francesco Botre, who is the director of the interduping level to in Rome. So we are trying to bridge the way between the production of performance by the athletes and what is being analyzed in the labs. So when you know what is being analyzed in the labs and you know how performance is being produced, then you can understand what is happening to blood or urine during performance production or after performance with training, with heat stress, with medication maybe, and all these confounding factors that do affect the quality of the samples that are being collected and then sent to the lab for analysis. And this is very important because if you have the right samples from the right athletes taking at the right moment, then you will be able to find a two positive where athletes are doping. So what we are working all along is currently all the confounders that do affect the samples that are collected and mostly in blood. So you may know that the athlete's bioligic passport is in an indirect way to monitor the athlete in longitudinal way, which means that you are collecting samples all the time and you are tracking changes in terms of your blood form that would reflect the use of doping substances or methods. And that is particularly interesting because you know that training, not only attitude training but also exercise training, training in the heat, so on that I think, I exported to cold weather, do have an influence on your red blood cells, on your plasma volume and those factors are very important to be investigated, to better understand how we can improve the way the athletes are tracked all the time with the athletes bioligic passport. So that's a key point that we are working on currently is also the way to improve this passport by understanding which maybe new biomarkers would be the right ones to be tracked for better detection in terms of sensitivity, detecting the two cheats, but also in terms of specificity, making sure that you are 100% sure that that negative is a true negative. And that's important. Absolutely, and I'm glad you brought up this idea that the athlete biological passport gives you this kind of longer term picture rather than just kind of that snapshot of one sample from an athlete because I think it is difficult to see without the context of what an athlete's natural normal is or how these things are changing over time and with training what might be going on with that particular sample. And I know this long term monitoring is really important in anti-doping for catching some of these unusual results that are coming back from testing and you've been collaborating with the follow-up of a PCC funded project examining performance monitoring for anti-doping with actually Professor James Hopkins at the University of Kent. So Raphael, can you tell us a little bit more about this particular project? Actually, in my lecture, I usually say that you tend to look or to search where it's possible to search rather than where it's doable. When you are using your keys in the park, but there is no light, then maybe you will be trying to see what the light is if your keys are there, even though you know that they are not there because you lost them where it's super dark. So in science, you tend to investigate and to do this research where it's possible to do, while you should know that trying to expand the light and bring some light in other places where it's more difficult to look at, that's the biggest challenge. So it's true that the detection for single samples and finding forbidden substances in urine or in blood is something that is still very important, but the way we are looking at the art of the health passport is also somehow helping to understand where or when the samples should be collected because you see those variations that may be normal or abnormal, and that might be related to performance. So the work we are doing together with James Hopkins at the University of Kent is trying to look at the performance production because people will think that, hey, this performance was extraordinary. So that art might be doped. And in fact, you can monitor the performance trajectory of the art is over time and see if they are improving their performance too fast. Maybe that's because they were training really hard, but maybe because they were doping. So what we are trying to do is trying to set the possible or the trajectory that would be normal for a given up, based on population data and see how it evolves over time to define some kind of the score of or excess performance. So excess performance would be some kind of performance improvement that would go beyond what is expected in terms of normal physiological adaptations due to training. And this can be done because we have this expertise in training and knowledge on how to improve performance by training, but also because we do collaborate with people who explain what is happening in terms of pharmacology with certain substances that do improve performance. So based on art is that have been caught for doping, then we can also track back their performance over time to see if there was abnormal performance right before or performance changes right before the moment they were caught. And this helps us to build some kind of model that we can apply for any art needs and then see if the performance trajectory for a given art needs abnormal and would require that more urine or blood samples are collected to better target that specifically. So what we are trying to set up is some kind of very practical tool that can be applied in track and field, but in other sports as well, where you can have the performance database. You can have for a given athlete his or hers performance trajectory over time and have some kind of flags that will just appear when you have abnormal performance changes that to do exceed what is naturally expected. And that is very practical because with all the athletes and the numerous samples that are collected all the time, human resources are often lacking to really target to write athletes. And by this means you will not say that an athlete would be sanctioned because he or she would perform too well. But of course this would certainly also have to target a new test in case of abnormal performances are detected. And this work is a very interesting collaborative work because we do provide anonymized data to the nurse of camp. They do apply the model. We do provide some data where artists have been caught or have been sanctions for doping. They are telling on the other hand if they are and then we are trying to see if the model is able to detect these abnormal performances. And then this is a way for us to make sure that we are matching the needs for the model to detect abnormal performances or doping only by looking at the performances. So of course this will not trigger sanctions based on abnormal performances. But again, this is a very practical tool to help the target which tests are being done on which athletes. Absolutely Rafael, I think this is a fascinating project and you mentioned specifically track and field. I guess I'm curious is the approach for calculating a score for excess performance? Would it be similar when you're looking at maybe some of these speed based sports or something that's more endurance based or strength based? Of course when you measure time for a 3k run on your own and try to improve your own time by training, it's very easy to see or to measure the fact that if you are six second faster, then you are six second faster because sections are very easy to measure and we are certain that that six seconds are six seconds and not something else. When you measure a variable in blood and might be hemoglobin concentration, it depends on several other factors. So measuring performances with very simple tools, kilograms or seconds is a way to be sure that the performance itself is very easy or very accurate. we know in science that the better prediction of performance is performance itself, we can be sure that the performances among the others are comparable. What is very important to notice in that context is the fact that we do not only look at the performance for one at it and see if that is running faster or slower, but we also include the fact that there are competitors. And if you have to run at the regional level, maybe the competition would not be as hard as at the Olympic Games. Of course, when you are prepared better, you are better in shape, you are peaking better for the Olympics than you would be for the regional championships. So of course, these factors are included in the model we are developing to ensure that we are taking in considerations all the factors that would be confounding the performance in the end. Phenomenal Sarafael, can you give us a little bit of insight maybe in terms of what your findings are for this research thus far? So in terms of practical applications, we are quite close to bringing a tool where you can just feed in performances and see how the performance evolves over time to have this longitudinal approach to detect excess performance. And this can be done for several sports. At the moment, what we are trying to do is to see if we can link any changes in terms of performances with biological data. So we tried to feed data that is existing from the added visual passport with hemoglobin concentration or with glycocytes percentage and to see if there are links between changes in your blood values and changes in performance. And this is of course difficult because when you are trying to do it with the EPO, then you will do that today because you want to improve your performance maybe in one month. It takes some time to build up your blood cells and there's a time gap between the moment where you do it and the moment when you have the performance that is being improved. So of course when you are measuring performance afterwards, you need to consider the delay between the moment where you would have been doping in the moment where you have the performance that is being improved. So that is the current challenge is to make sure that we are able to tackle the problem of doping not by saying, "Hey, this performance is abnormal right now, but we cannot do anything because doping occurred maybe five weeks ago." So there's something that has to be taken over time, over a longer time, to define the targeting strategies and to better delineate the target groups in each sport. But technically I would say that the model is really robust, relying on mathematics that are very strong and that we are able to develop or to implement some kind of tool to give some scoring for the athletes. Currently we are doing that for track and field, but it is also being done by Professor Marker for weightlifting and we are in contact with several actors and stakeholders in the field can be the athletes' integrity unit but also the ITA and international testing agency also based in Lausanne to bring this tool beyond the research part in academia or in research papers. This is really done to improve a doping in the field and we strive to have something that is useful not only for the interest of science but for the interest of the athletes that are doing the best to perform without the open. Certainly it sounds like this tool just has a lot of potential to be added to anti-doping programs as another monitoring approach to augment. Some of the current and maybe more traditional testing in analysis efforts to try to keep sport clean. So that is really important work that you're doing there and I know Raphael, you are an athlete biological passport expert I would say. We've been working on and analyzing this athlete biological passport for some time now and it's continuing to evolve so when you think about the athlete biological passport more broadly, what are some of these enhancements or things that you would like to see that you think it could have the biggest impact? As soon as in Lausanne we are lucky to have the legacy of Professor Marcel Sorgi who is a little bit further on the grain behind the athletes' battle passport and it's been evolving a lot for the last 10 years since it was first implemented in 2009 and this monitoring of blood values and also steroid values in urine is currently moving forward by means of trying to include new biomarkers. For example for the steroid in urine it's true that there are many confounders that do affect the values that you have for the steroid in urine and one path is currently to attract to collect more blood samples and to see how the steroids are in urine. This is interesting because of course if you take the open substance it has to be metabolized in your body and it will be excreted for some part in urine but if you are measuring things in blood then you are much closer to the doping scenario so that's interesting because you can have a sharper picture of any doping scenario if you are measuring this value in blood and this is partly important also for measuring steroids in female athletes because in women you might have very low values for these steroids and this would certainly also impact the variations that you can observe in urine so that's for the steroid passport. Then for the blood passport we are currently exploring or trying to find biomarkers that are robust enough to complement the current approach where hemoglobin concentration and the exercise are the key markers affected by doping for one part but also by other factors that are included in training training in the heat training at altitude where plasma volume changes do affect the readings for the active metrol passport. So one work that we are doing currently is also trying to find a way to better assess how plasma volume changes in variations can affect readings for the active virgin passport. You have flags for the passport when you have values that exceed the individual limits but this might be naturally due to plasma volume changes due to training or to sonar bathing for example and this is important to be considered. So in the end for the ADP they always experts that have to interpret variations of the passport and bringing tools for them to have a better interpretation for them to know that we have identified the confounders that have influence plasma volume in that sense that is very useful for the experts because then they can provide a more robust interpretation of changes and this certainly helps to spend more time on difficult cases or cases that do need special attention because they are likely due to doping rather than to altitude training or exposure to the heat and that is very important for us and we do work really well together with the AP team at water to try to improve the passport to implement this knowledge on the plasma volume changes into the passport for the experts to benefit from this scientific knowledge. Absolutely and I think a big challenge in anti-doping is that you are dealing with such small changes. So when we're talking about these plasma volume changes just to give our listeners some context what sort of volume changes are we talking about. So if you imagine that you would try to do blood doping by adding red blood cells to your body this is being done because you want to improve the convection of oxygen to your muscle to improve the oxygen consumption and your aerobic and endurance performance and this works really well so a very small amount of blood that is being transfused will help you select and improve performance but that is measurable and there we talk about a few or maybe 10 or 15 grams of hemoglobin so you can imagine that the transfusion of about 100 milliliters of your own blood will impact your endurance performance by about maybe 5 percent so that's not a lot but that's sufficient to make a two difference in terms of endurance performance. So these changes are difficult to track because of the accuracy of the methods that are being used to analyze this but of course we are trying to set up the methods to make sure that the values that you are measuring are accurate and robust enough to see that some change is due to the open rather than to natural physiological changes and that's the challenge but that's how the reality version passport was set up from the beginning and tried to discriminate doping from non-doping status based on the priors based on the fact that you have certain values of hemoglobin or with a chialis answer so this is working really well in reducing the possible amplitude of doping I would say that has not suppressed blood doping but now I actually know that they are being tracked over time and that are given change due to blood doping would certainly be detected if it's too big so that means that some athletes now do some kind of a micro dosing in the IPO doping and that of course is still doping is still forbidden but that certainly reduces the changes or the improvement in performance and that's a really step towards a fairer sport but of course we need to develop methods to better track the artists that are doing this and that might also be done with some machine learning tools artificial intelligence where instead of having to read let's say 100 passport from 100 athletes you can focus maybe on five because you have a tool that has been detecting that the pattern is very normal or the pattern is abnormal to highlight the passports that do require more attention absolutely Rafael I know this work that you're doing on the athlete biological passport is so critical are there other projects that you have in the works that you're really excited about and want to share with us it's important to have a look at the whole picture when we are talking about the athlete's facial passport and then you think about then blood doping so if we talk about blood doping we think about blood transfusion or IPO doping and these do impact the red blood cells that you have in your body so we are looking currently also at the shape of the red blood cells is the shape modified or the elasticity of the membrane of the red blood cells is being maybe modified by the fact that you have had some blood that was stored and freezer for some time. So we are working really on single red blood cells to see the properties that are being changed either by the opening or by training to better understand how the open impacts the red blood cells directly and how this can be discriminated from training. So trying to keep the big picture with the athletes performing the highest level with the athletes by the passport being some kind of holistic tool to have this monitoring, but also having a look really at the small effects of doping in the single red blood cells is something that is important also to us to have this overall understanding of how doping is impacting the samples correct for the athletes. Absolutely. And I think developing this multi-pronged approach is going to be essential for anti-doping going forward just because there are so many different ways that things could be changing. And I think the cheaters will continue to evolve in their methods of cheating to try to get around some of these tests that you're developing. So we talked about some of the challenges already that you face in anti-doping but Raphael are there other challenges that you're facing in anti-doping research that you want to discuss? When we are talking about the challenges that we face in anti-doping research, maybe you can only remove anti-doping and say what are the challenges that are faced in research? And those are mostly the same I would say, which means that it's the question of time and the question of resources. If you have enough money, then you can hire more people and then you can do the research a bit faster. And that is of course helping to provide results that are useful in the field. What is important for anti-doping research is to make sure that we bring the fight against the open forward and that we bring practical tools and practical answers to research questions that can help in the field. I can give one example. We did this research a few years ago on the impact of the body position when we were collecting blood. Let's say that you have a blood sample collected for the ADP and you need to be seated with the feet on the ground for 10 minutes. But let's say that you are in a second race and you have to be in a waiting room, 15 meters away from the table where the sample will be collected. So you are being seated there because there are more leads that are being tested and then you have to stand up and work 15 meters and then sit down and wait for 10 minutes again. And this of course is a little annoying because maybe you have been sitting for half an hour already. So what happens if you only have to work, let's say, less than 15 meters, do you need to be seated again for 10 minutes or five minutes sufficient. So that was a question that we did answer and we could show that hey, five minutes is actually enough. Well, to stabilize the values to the values, the premise value. The other thing is that word path organization says that normally if you take blood, you should be in superimposition, you should be lying in that would be more comfortable. But we have shown that if you are lying instead of sitting, then you would have changes in the plus and the room that do affect the readings for the added bedroom passports. So those are two questions that are very simple to answer. But needed a robust scientific background to be answered. And this of course affects again, a few months to be investigated. So in research, we first face the fact that we need some money to perform research and then we need to justify why we are doing things. And that needs an ethical approval. So is that ethically correct to administer a tester or to a woman to test for the variation in the steroids in the blood are you in just because you want to improve the fight against the opening. So that answer is easy to answer when you're working because of course it's important in antidegroping. But for the general population, maybe it's not the priority. And in terms of ethics, it's not correct to administer some medication to someone who doesn't need it. So we do face this question or these issues about the ethics of research in antidegroping. And that's something that we do try to improve by working closely with the local ethics commission. And that is an important part. And then of course, the time frame is important because as I said before, the antidegroping world, when it's funding projects needs answer really quickly. You cannot say, okay, let's work on this for the next five years and see what comes out. We really need like very specific research question. And the answer is as fast as possible to improve the detection of certain substances or cheating methods before the ethics move to something new. And that's something that is important trying to be as close as possible as to the doping practices that are detected or that are discussed on the field. Absolutely. Raphael, I'm so glad you brought up these examples of just some of the challenges of logistics of antidegroping research and antidegroping testing operations as well that I think a lot of people maybe don't think about or just take for granted that all of this work and thought and research is going into developing the protocols that will be most successful in the field. Yeah, it's true. It's a lot of thing behind to design realistic and really ecological in terms of ecological because you are close to what is what is done in the field. Trying to test to have studies that are done with elite athletes, studies that are done with the woman. We are doing a lot of research in women currently because there is a clear lack of data and knowledge on what is happening with the urine or blood in the woman when you're we're going through doping away. You are having the highest performance level. And that's something that we try to do and to develop here in the assembly. Absolutely. And you shared a couple of research successes, but I guess do you have a favorite research success that you would like to tell us more about? You talked about the fact that we are really close to the operations and that is a good example because a few years ago we did work closely with a lab in Kenya and the athletes integrity unit to set up the antidegroping lab in Nairobi in Kenya. And what you can see after a few years of operations is the fact that this has clearly had to make the antidegroping much closer to where doping could possibly occur. And this has resulted likely more tests that could be done because you have a lab that is closer to where the athletes are. And this certainly results also in more positive cases that you have seen lately in Kenya because the Arctic's integrity unit is doing a great job in using the resources that are locally available to have athletes tested and tested more because this lab was set up. So that was a big challenge to set up this lab for the athletes but you passed both in Nairobi a little bit from scratch. But this was really, I would say, a success because then you are answering true need in terms of testing in the field. And I think that that was a mix between the operations and also the regulations are very good collaborations with water and that is federation and the local Kenya authorities to set up this lab that is very useful in tracking the doping in Kenya. Absolutely. I think because sport is so global in nature, having these resources available around the world in all of these different places is critical for making sure that everyone is being treated equally in terms of testing for athletes and in terms of having that fair playing field around the world. So I think that is wonderful the work that you've done there. And we've talked about a lot of these research questions that you've been answering and some of the work that you've been doing on the scientific side. But you're also active in the education space and you've got an interesting education initiative where people can actually earn this certificate in advanced studies in anti-doping sciences. So I'd love to talk more about this Raphael. Can you tell us a little bit more about the certificate program? So the certificate advanced studies or a class in anti-doping sciences was developed to again, as I said at the beginning, to raise the bar in terms of the expertise that is used in the anti-doping operations. There are many people that are being hired by international federation or by national anti-doping organization that do have a super high level of education in management or economics or life science. And bringing together experts from different fields or different topics that need to be addressed in anti-doping can be detection, it can be compliance, it can be legal aspects. It was important to us to bring some kind of very broad and holistic education to these people working on the field in operations and make sure that they would have the best knowledge when they come out with the certificate to operate directly and more efficiently in their anti-doping organization. So we've had a very successful first edition with people coming from all around the world between China, Jamaica and other country, Brazil, Switzerland. And this was very interesting because you had the occasion to network between the people but also to network between the experts that we gathered to lecture in this course. Managing that was really appreciated also by the lecturer themselves because they noticed that they have a lot of expertise and experience over time. People that have been working in anti-doping for more than 30 years are really willing to share their knowledge. And that is very important that this knowledge is not lost because the anti-doping communities and network and community where you can share the expertise between the laboratory and material with the NATO in Poland and maybe an international federation that is based in Mozambique. And all these discussions between the experts in the field were made available in this cast because it was set or defined to have a very broad education program that gives you an academic degree not to show that you have a diploma but to make sure that you could reach the highest level of education in anti-doping and raise the bar in terms of the operations that is needed in anti-doping. Absolutely. I think this is another example of an exciting success. And I think again, like you said, raising that bar bringing up the knowledge, the awareness and just bringing the community forward in anti-doping is just an amazing endeavor. So I guess looking forward to the future, Rafael, if you had all of the resources imaginable, is there one problem in anti-doping sites that you would want to solve most or maybe one challenge that you would want to tackle most? That's a very difficult question to answer because obviously we never get all the resources to like. But one thing that is important to remember is that in anti-doping the athlete is at the center. Why is the anti-doping system? It's because we wish that the competition is fair for all the participants. And we wish that because in terms of education or how we educate our children that you are happy and fair against the competitors because two winners actually never cheat and cheaters actually should never win. But that's maybe another question. But I would say that developing tools to improve the way we are protecting the athletes that are not developing would be the way I would go to. It's not about having more money to get more samples from more athletes. Those resources do exist somewhere. And it's just a question of priority to say instead of having all this huge amount of money for TV rights, maybe some money could go for a better image of our sport. And this is being an origin improved over time, I think. But we do forget maybe that if there is, let's say, a prevalence of the opening of 20%, that means that 80% of athletes that are showcased on the screen on TV or in competitions are actually not developing. Let's say 20%, I have an included, we did some governance study where we had a number that was close to that 15% in athletics. But let's say that there's still a vast majority of the athletes that are not developing. So the effort in the looping should also be made to ease the way the looping is done and make the life of these athletes a little bit easier. Some of them would actually agree to have some kind of chip on the skin during their career, to have the values tracked and would be really more than happy to show that they are not developing. And trying to find ways that are acceptable for the integrity of the athletes, but that are also fair towards the athletes that are not developing is something that is important to my eyes. And I would say that I would spend some resources to do this. The other thing I would think system is also trying to gather more data on knowing what is a normal value for an athlete. And that's not only for the athletes, but also especially for the women who are little is known. So I would also spend a lot of resources on research on specific production of performance in human, I would say that's the key point I would focus on. Not only if I had a lot of resources, but also because I'm interested in those topics, I would say. - Absolutely. And I think it's so difficult to know and to be able to catch what's abnormal if you just don't have the data on kind of these normal physiological variations, which do differ between men and women. So I think that is a definite challenge. - Yeah, I think that's the interesting part we like about science is the fact that you try to answer a question with a research project. And maybe you get the answer often you don't get the answer, but you just have more question in there. - It keeps it interesting. Well, Raphael, if our listeners are intrigued by our conversations today, and they would like to learn more about you, more about the Red Center, and more about what you do, what is the best way for them to do so? - Yeah, they could have a look at the website, which is unil.nil.ch/reds, very easy. And if you just type my name in Google, then you will also find the contact information to make sure that you can just give us a phone call. And once you are passing by in Ozan, you should make sure that you can come by, have a coffee and visit our lab. We will be happy to share what we are doing and to give more information and to make sure that we can maybe also set up new collaborations with people that are interesting in this research, because even though we have a small team, we really tend to build up this collaboration and act as a facilitator in the Anthodoping Network. - Fantastic, well, Raphael, we appreciate your hospitality. We appreciate you spending time and sharing your insights with us today. It was such a pleasure to have you on the show. - Thank you very much for having me. I'm really glad to share this little knowledge I've gathered over a few years I've been working on the looping and I will be especially glad to exchange with the listeners at the best occasion and next time we can meet live, hopefully. - That sounds wonderful, Raphael. Great to have you here. Listeners are wonderful to have you here with us as well. And if you haven't already, it would be fantastic. You could rate our podcast and leave a review on your favorite podcast platform. And listeners, please note that the Anti-Doping podcast features a wide variety of clean sport experts. And episodes may include statements and or viewpoints that do not necessarily reflect the views or values of the PCC. Thank you and we look forward to seeing you on the next episode of the Anti-Doping Podcast.