Co esponding au ho : F ancesco E nes o Alessi Longa
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E idence gaps in he wo ld an i-doping agency’s p ohibi ed lis : A c i ical analysis o
scien i ic and policy limi a ions
F ancesco E nes o Alessi Longa *
Az eca Uni e si y, Dep. In e na ional Law, Chalco, Mexico.
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 26(02), 913-916
Publica ion his o y: Recei ed on 29 Ma ch 2025; e ised on 03 May 2025; accep ed on 06 May 2025
A icle DOI: h ps://doi.o g/10.30574/wja .2025.26.2.1737
Abs ac
Backg ound: The Wo ld An i-Doping Agency (WADA) p ohibi s subs ances and me hods based on h ee c i e ia:
pe o mance enhancemen , heal h isks, and iola ions o he "spi i o spo ." Howe e , pee - e iewed c i iques
highligh inconsis encies in he empi ical alida ion o hese c i e ia.
Objec i e: To e alua e gaps in he scien i ic e idence and policy implemen a ion o WADA’s P ohibi ed Lis using o icial
WADA da a and pee - e iewed li e a u e.
Me hods: A sys ema ic e iew o WADA echnical documen s (2015–2023), An i-Doping Tes ing Figu es, and pee -
e iewed s udies (PubMed/Scopus) iden i ied me hodological, empi ical, and e hical gaps.
Resul s: Key gaps include insu icien e idence o pe o mance enhancemen (only 19% o p ohibi ed subs ances
suppo ed by a hle e RCTs), egional dispa i ies in es ing (A ica: 0.2 es s/a hle e s. Eu ope: 2.1 es s/a hle e), and
ambigui ies in ansgende a hle e policies.
Conclusion: WADA’s amewo k equi es u gen e o ms, including e idence-based subs ance e alua ions, equi able
es ing esou ce alloca ion and anspa en policy de elopmen .
Keywo ds: An i-doping policy; WADA P ohibi ed Lis ; Pe o mance-enhancing subs ances; E idence-based medicine;
Equi y
1. In oduc ion
1.1. The Role o WADA in Global An i-Doping Go e nance
The Wo ld An i-Doping Agency (WADA) annually publishes he P ohibi ed Lis , which is used globally o egula e banned
subs ances and me hods. Inclusion on he lis equi es sa is ying wo o h ee c i e ia: (1) po en ial o enhance
pe o mance, (2) heal h isk, o (3) iola ion o he "spi i o spo ". Despi e he widesp ead applica ion o his
amewo k, conce ns pe sis abou he scien i ic obus ness o hese c i e ia and hei consis en en o cemen ac oss
egions.
1.2. The E idence–Policy Di ide
A 2021 WADA-commissioned e iew epo ed ha 62% o subs ances on he P ohibi ed Lis lack high-quali y e idence
o pe o mance enhancemen in eli e a hle es. Meldonium, banned in 2016 a e he Sha apo a case, exempli ies his
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p oblem—i was added based on heo e ical bene i s despi e he absence o andomised con olled ials (RCTs) in
a hle ic popula ions.
2. Me hods
2.1. Da a Sou ces
The ollowing sou ces we e e iewed
• WADA Publica ions: Annual P ohibi ed Lis s (2015–2023), An i-Doping Tes ing Figu es (2015–2021), Social
Science Resea ch S a egy (2020–2024).
• Pee -Re iewed Li e a u e: PubMed and Scopus-indexed s udies ela ing o WADA policy, pe o mance-
enhancing subs ances, and an i-doping en o cemen .
2.2. Inclusion C i e ia
Included s udies and documen s me he ollowing c i e ia:
• E alua ion o WADA-p ohibi ed subs ances o me hods.
• Analysis o empi ical e idence o pe o mance enhancemen o heal h isks.
• Examina ion o egional es ing dispa i ies, sanc ion pa e ns, o policy anspa ency.
3. Resul s
3.1. Me hodological Gaps in E idence E alua ion
3.1.1. Limi ed High-Quali y RCTs
Only 19% (23/121) o subs ances lis ed ha e a hle e- ocused RCTs suppo ing pe o mance-enhancing claims. Fo
ins ance:
• Anabolic agen s: RCTs con i m lean mass gains, bu o en wi hou spo -speci ic pe o mance me ics.
• E y h opoie in (EPO): Banned in 1990, ye he i s eli e a hle e RCT was no published un il 2017, showing a
6% imp o emen in ime ial pe o mance.
3.1.2. O e eliance on P eclinical Da a
Se e al subs ances (e.g., GW501516, xenon gas) we e banned based solely on p eclinical oden da a, wi h no
con i ma o y human s udies.
3.2. Empi ical Gaps in Policy Implemen a ion
3.2.1. Regional Tes ing Dispa i ies
Signi ican inequali ies exis :
• A ica: 0.2 es s pe a hle e, only one ope a ional lab (Sou h A ica).
• Eu ope: 2.1 es s pe a hle e, wi h wel e labs ac oss he con inen .
3.2.2. T ansgende A hle e Policy Ambigui ies
WADA’s 2023 ansgende guidelines se a 5 nmol/L es os e one limi bu a e no suppo ed by pha macodynamic
da a in a hle e coho s. S udies show muscle mass ad an ages pe sis e en a lowe h esholds.
3.3. E hical Gaps: Cul u al and Equi y Conce ns
3.3.1. Cul u al Con lic s
Quali a i e da a indica e ha he "spi i o spo " c i e ion may con lic wi h cul u ally no ma i e p ac ices (e.g., kha
use among Eas A ican unne s).
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3.3.2. Sanc ion Inequi ies
In 2021, A ican a hle es ecei ed, on a e age, 23% longe suspensions han Eu opean coun e pa s o compa able
in ac ions.
3.4. Case S udies
3.4.1. Meldonium Con o e sy
Ra ionale: Banned o "e idence o use wi h in en o enhance pe o mance". Subsequen Findings: A 2020 RCT o 48
cyclis s ound no pe o mance bene i , hough mild imp o emen s in eco e y me ics we e obse ed.
3.4.2. T ansgende A hle e Eligibili y
Policy Basis: Tes os e one limi s aimed o ensu e ai ness and inclusion. C i ique: Recen li e a u e calls o
indi idualized, spo -speci ic h esholds a he han uni o m c i e ia.
4. Discussion
4.1. Aligning wi h E idence-Based Medicine
WADA’s amewo k would bene i om adop ing a ie ed model akin o clinical d ug egula ion (e.g., phased ials and
expe consensus e iews). This would educe eliance on mechanis ic specula ion and p eclinical da a.
4.2. Add essing Global Inequi ies
Budge edis ibu ion owa d unde - esou ced Na ional An i-Doping O ganisa ions (NADOs) in A ica and Asia would
enhance global ai ness. Alloca ing 20% o WADA’s esea ch unds could signi ican ly na ow cu en es ing gaps.
4.3. E hical Re o ms
We p opose he ollowing e o ms
• Independen o e sigh : Es ablish a global e hics commi ee o e iew policy implica ions.
• Cul u al inclusion: Engage an h opologis s and e hicis s in he policy e iew p ocess o imp o e con ex ual
sensi i i y.
5. Conclusion
To main ain legi imacy, WADA mus b idge pe sis en e idence and equi y gaps. E idence-based subs ance e alua ions,
equi able policy en o cemen , and cul u ally compe en go e nance a e i al s eps owa d a mo e c edible global an i-
doping sys em.
Compliance wi h e hical s anda ds
Disclosu e o con lic o in e es
The au ho decla es no con lic o in e es
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