![BANNED. A file picture made available in September 2015 of the production of 'Mildronate' at the pharmaceutical company Grindex in Riga, Latvia, 23 November 2010. 'Meldonium', also known as 'Mildronate', is produced in Latvia and is used to treat slow blood flow or a lack of it, known as ischemia. Maria Sharapova tested positive for Meldonium during the 2016 Australian Open. Photo by VALDA KALNINA/EPA]()
MANILA, Philippines – Doping in sports is once again thrust into the spotlight in the aftermath of Russian tennis star Maria Sharapova admitting to failing a drug test on Monday, March 7.
The 28-year-old tested positive for Meldonium, a drug she claimed she had been taking since 2006. The substance, which is used to treat heart troubles but is not approved for use in the United States, was on the World Anti-Doping Agency's (WADA) watch list in 2015 and has since been moved to the prohibited list as of January 1, 2016.
The 5-time Grand Slam champion, who tested positive on January 26, said she received an e-mail with a link to the revised list of banned substances for 2016 but never clicked on it.
She is currently "provisionally suspended" by the International Tennis Federation and is facing 4-year ban for the violation.
Meldonium is manufactured in Latvia and has been determined by WADA to be used by athletes as an improper energy and stamina helper.
But how does WADA come up with the annual Prohibited List? How does the international agency determine which drugs should be banned? Where can this list of banned substances and methods be found?
A year-long process
The very cornerstone of WADA's efforts to "protect the Athletes’ fundamental right to participate in doping-free sport and thus promote health, fairness and equality for Athletes worldwide" is what it calls the Prohibited List, or simply the List.
First published in 1963, the List contains all of the substances and methods that are prohibited for use by athletes, whether it's at any point in time, during competitions, or in specific sports only.
WADA, which took control over preparation and publication of the List from the International Olympic Committee since 2004, updates the List every year effective on January 1. But before substances are put on the banned list and sent to athletes, WADA first embarks on a year-long process of studies and investigations.
It starts with the List Expert Group, which is composed of scientists "chosen for their international expertise." The group meets 3 times a year and is responsible for making recommendations and revisions to the List.
The group's first meeting takes place in January, where they "define new and key areas of activities and allocate tasks."
They work on those tasks over the next few months and regroup in April, where they prepare the Draft List. That List is then published and circulated to stakeholders around June to July for consultation purposes and any comments.
By August those comments are carefully considered. Relevant comments and suggestions are then integrated into the Draft List, which is circulated once more to a List Committee.
The group reconvenes for the third and final time come September to review comments and the Draft List once more before they send it over to WADA's Health, Medical and Research Committee for discussion and final recommendation.
With that final recommendation integrated, the List then finds its way to the WADA Executive Committee, which is in charge of finalizing and approving the List during its September meeting.
The final List, considered as an International Standard, is then published on October 1 and will take effect on January 1 the following year and will be valid through to December 31.
Where can you find the List?
The full List and all the processes involving its preparation and publication can be found on WADA's dedicated website as well as in WADA's downloadable PDF version of the Code, which is "the fundamental and universal document upon which the World Anti-Doping Program in sport is based."
On WADA's website, the List can easily be accessed and navigated through links on the upper the left-hand side of the page.
There are specific links for those Prohibited At All Times, Prohibited In-Competition, and Prohibited In Particular Sports – all with drop-down links enabling navigation specifically to Prohibited Substances and Prohibited Methods per category.
You can also navigate the Prohibited List By Substance or By Method.
Apart from online publication, the List can also be constantly reviewed anywhere using a smartphone app.
The app, which is compatible with iOS mobile devices, is called the WADA Prohibited List 2016 and can be downloaded for free through the App Store.
The app contains the year's updated List with navigation similar to the one on WADA's website. Prohibited substances and methods can also be searched alphabetically through the app.
Meldonium, the substance Sharapova and a number of other Russian athletes have been found guilty of taking, is on the "Substances Prohibited At All Times" list, under S4. Hormone and Metabolic Modulators, even more specifically under Metabolic Modulators.
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Criteria for inclusion to the List
WADA follows a specific criteria to determine which substances or methods should be included in the Prohibited List.
As outlined on the Code, the criteria are as follows:
1. If the substance or method meets any two of the following 3 criteria:
a. Medical or other scientific evidence, pharmacological effect or experience that the substance or method, alone or in combination with other substances or methods, has the potential to enhance or enhances sport performance.
b. Medical or other scientific evidence, pharmacological effect or experience that the Use of the substance or method represents an actual or potential health risk to the Athlete.
c. WADA’s determination that the Use of the substance or method violates the spirit of sport described in the introduction to the Code.
2. If there is medical or other scientific evidence, pharmacological effect or experience that the substance or method has the potential to mask the Use of other Prohibited Substances or Prohibited Methods.
Finally, WADA specifically states on the Code that once it deems a substance or method as prohibited, it will be considered "final and shall not be subject to challenge by an Athlete or other Person based on an argument that the substance or method was not a masking agent or did not have the potential to enhance performance, represent a health risk or violate the spirit of sport."
Monitoring and TUE
Aside from substances and methods published on the List, WADA also has a separate list for its monitoring program.
WADA publishes a list of monitored substances and methods as they track potential "patterns of misuse in sport."
Laboratories are responsible for reporting detection of monitored substances in athletes – and whether it was used in-competition or out-of-competition.
According to the Code: "The reported Use or detected presence of a monitored substance shall not constitute an anti-doping rule violation."
Meanwhile, an athlete is allowed to apply for the Therapeutic Use Exemption or TUE.
TUE, according to the Australian Sports Anti-Doping Authority's website, is "an exemption that allows an athlete to use, for therapeutic purposes only, an otherwise prohibited substance or method (of administering a substance)."
WADA has detailed provisions in its Code for athletes wishing to apply for a TUE to their respective International Federations or National Anti-Doping Organizations.
Links to WADA's Prohibited List:
1. Prohibited At All Times
2. Prohibited In-Competition
3. Prohibited In Particular Sports
– with reports from Agence France-Presse/Rappler.com
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