Interview - Agency for Cycling Ethics
An interview with Dr. Paul Strauss about the A.C.E. anti-doping initiative.

By Ferren Christou

In September of 2006 partners Dr. Paul Strauss and  Paul Scott announced their initiative for clean cycling with the formation of the Agency for Cycling Ethics. The agency goals was to establish an A.C.E. community of teams riders and sponsors committed to a environment free of performance enhancing drugs, stating, "We are the advocates for the riders and the teams and empower them to take responsibility for their own behavior and bring the ACE Clean Cycling Initiative to the devotees of cycling and fans."

The initiative institutes a multi pronged attack in their anti-doping effort including education, counseling and an innovative scheduled testing for amateur and professional teams, their sponsors to reach the lofty goal of a drug free cycling. It wasn't long after their launch that Jonathan Vaughters signed with ACE to institute the program in his Slipstream powered by Chipotle team.
In the last year two ProTour teams T-Mobile and CSC have started anti-doping programs within their teams each has their own approach.

The ACE program is set up to function not only for individual cyclists but for any number of teams that seek an independent group to provide an anti-doping program within their teams as a line of first defense not only to eliminate doping but to also set a standard of ethics and personal integrity through testing, education and counseling for teams and riders. As this is one step to a solution of drug free sports we felt it was important to interview one of the founders of ACE about their program. But first a bit about the Paul Scott and Dr. Paul Strauss.

Paul Scott - Chief Operating Officer
Mr. Scott was a chemist at the UCLA drug testing lab early on in his professional career. After several years as an Anti-Doping research chemist he decided to go to law school. He practiced corporate law for six years before deciding to return to the UCLA lab - this time as its Director of Clients.

His responsibilities at the lab included Anti-Doping cases, overseeing drug testing protocols and interacting with outside agencies to ensure the integrity of those testing protocols and the Anti-Doping system. He has left the UCLA lab to work at ACE on a full-time basis.

He is an amateur racer in the Southern California racing circuit. He brings to ACE a unique perspective on the problems of doping in the professional and amateur cycling communities as well as being a co-author of the ACE Clean Cycling Initiative.

Paul Strauss M.D. - Chief Executive Officer
Dr. Strauss has twenty years of clinical practice at academic institutions on both coasts of the United States. He is currently in practice at Cedars Sinai Medical Center in Los Angeles. He has also been a CEO of an innovative healthcare information technology company as well as a software engineer.

He has been a competitive cyclist for several years in the Southern California race community. Currently he is on the Board of Directors of LaGrange, a large cycling club in Los Angeles promoting clean cycling as well as cycling advocacy and awareness to the general public.

Being a physician, a USA cycling certified coach as well as training and racing in the amateur circuit, Dr. Strauss understands the issues of Anti -Doping from the physician and athletes perspective and a co-author of the ACE Clean Cycling Initiative.

Ferren Christou: Could you define your roles in forming and operating ACE? What led you to undertake such an ambitious program? I think those in the cycling community expect the anti-doping agencies or the teams themselves to take this route, but may find it surprising that an independent body has been created to provide an alternative to the current testing system. Also, did a dissatisfaction with the current system factor into the ACE project?

Dr. Paul Strauss: ACE was conceived by Paul Scott and I while driving to a local bicycle race. We recognized the need on both the professional and amateur levels to approach the problem of doping in a different way.

The current established system is based on punitive actions when a banned substance is found. The Agency for Cycling Ethics uses a model of following biomarkers for an athlete with weekly testing. Biomarkers are well recognized and mostly routine laboratory tests that change as a result of taking performance enhancing drugs.

We are following three areas of performance enhancing drugs. First Hematocrit, Hemoglobin, and Rectulocyte count which would predict blood doping by either transfusion or EPO. Second we are looking for the metabolites of steroid metabolism. And finally we are following growth hormone.

Ferren: Could you explain the contract ACE will enter into with a team? Is it possible for individual riders to join the program? How will we know which teams are in the ACE program? What circumstances could cause a team to have their ACE affiliation severed?

Dr. Paul Strauss: The contractual obligations of the Teams to ACE are specific and have terms to prevent athletes who are even just suspected of doping from riding. At that time an internal investigative process is begun by ACE and the team to rule in or rule out doping. Concurrently an education and counseling program is initiated for the athlete. The discussions with the athlete are confidential, non-threatening and brings the athlete into the investigative process.

If at any point ACE, feels the teams are not adhering to our ethical guidelines, we will terminate our relationship with the team. We will not have our ethical code violated and have ACE's testing programs abused and used for a purposed that they were not meant for.

Ferren: Team Slipstream is the first team that has entered the ACE program. This seems to be a great start, as Slipstream has a very ambitious plan for it's future. How does ACE plan to increase its affiliations and make a significant difference in the pro cycling community? Are there plans to engage teams outside of the US?

Dr. Paul Strauss: Team Slipstream is a group of young developing riders who have very strong opinions against the use of performance enhancing drugs in the pro peloton. They look at this testing program as a way to show the sport and the public that they ride clean. We are excited to be working with them.

Frankie Andreu, our director of clients has approached almost all the major domestic teams who want to participate in our program. As new financial resources from sponsors come into ACE we will bring more teams into the program.

Ferren:  I understand that commercial medical patient sampling sites will be used for some of the sample collection. Could you outline that procedure, and the sampling process in general? How does DNA profiling fit into that system and do the riders have to provide their DNA? Will this system work for sites around the world? And how will in-competition tests be carried out?

Dr. Paul Strauss: The use of collectors, going to athletes homes and in competition testing at events, is a very time consuming, expensive, and labor intensive process. To expand the volume of tests per year, we needed to be innovative in our approach.

We are utilizing Quest Diagnostics, the largest commercial laboratory in the US and their European resources. Athletes are scheduled to go to Patient Service Centers and have their blood and urine specimens taken. There are sophisticated safeguards to ensure the authenticity of specimen collection such as DNA testing the specimens for athlete identification. One thing to mention, there is a misconception as what DNA testing means to the world of anti-doping. It is not a magic bullet, but is just like a finger print, it will match up a specimen or a bag of blood to a particular athlete.

Ferren: Who will be testing the samples? How has the testing package been developed? Will you be using tests that don't meet the WADA criteria for acceptance? For example, how are you looking for HGH doping, will you be using the tests that WADA has in the works?

Dr. Paul Strauss: As mentioned, we are working with Quest Diagnostics. There really are no standard criteria for longitudinal biomarker testing as of yet. It is such a new science as applied to the field of doping. We are using recognized medical standards and pharmacological information to begin to understand the criteria that we would suspect doping and pursue further testing and investigation of an athlete. Even the HGH test is the application of a well known medical test with criteria applied in a new way.

Ferren: How will the tests results be interpreted? Are there values that will indicate a problem (such as the stimulation index WADA uses to root out suspicious blood manipulating behavior), will you set acceptable parameters for each rider, or will you rely on human intuition and the interpretive expertise of your staff? Will there be a combination of these methods?

Dr. Paul Strauss: Paul Scott an former chemist at the ULCA drug testing lab is well qualified to interpret the raw data. As well as myself, a physician with 25 years of clinical experience. We will also draw on the resources of the research division of Quest Laboratories. Saying that, the use of biomarkers in athlete anti-doping is very new and we will be constantly reevaluating the program and our criteria.

Ferren: What happens when a rider's tests show a problem? What action will the team be expected to take? Will different teams be expected to consistently sanction their riders?

Dr. Paul Strauss: As we are following a biomarker and there is a change in the values, which raises our suspicions, riders first must be pulled from the peloton as per contractual obligation between A.C.E. and the team. Riders will have their general health reevaluated, direct discussions with the rider will begin as well as more frequent and specific testing. These procedures will bring the rider into the process as well as continuing to enforce to riders the importance of riding clean. It takes away the idea that they might just “get away” with doping as the current system tests randomly and infrequently.

Ferren: Are you concerned that riders will find ways to mask their doping even while being tested in the ACE program? That they will have doctors who monitor and manipulate their parameters in order to fool the tests. And that teams will be using ACE as a cover for their doping programs?

Dr. Paul Strauss: If we are very liberal in raising our suspicions of doping, it would be very hard for an athlete, even under medical supervision to manipulate the tests and hide doping.

From the perspective of medical science, what we are doing is simple and well established, therefore making it difficult to fool the tests. I must also mention, that ACE’s ethical and moral codes, which the teams are contractually bound be, will prevent Teams from using ACE as a pre-testing program. This again is why we feel that ACE’s independence from the teams and sponsors is a necessary requirement to maintain the credibility and integrity of the program. Internal anti-doping programs always have the potential problem of violating ethical standards because of internal team and economic pressures.

Ferren: Is there a chance a rider could still test positive as a result of WADA's strict liability requirements?

Dr. Paul Strauss: We are dealing with a human process and the science of testing is not infallible, I will only assume that an ACE clean rider could test positive by WADA but I expect it to be a very small possibility. I think the chances of that are extremely small since we are testing athletes tens times more frequently than WADA.

Ferren: There is a burgeoning interest in the use of bio-markers. For example the US Anti Doping Agency and the British government have recently held conferences on the issue, and the T-Mobile and CSC teams are implementing such programs. Are you networking with the ADAs or other organizations?

Dr. Paul Strauss: We are an independent entity which we feel is important to the integrity of the process as mentioned before. However we all have the same goal to clean up the sport of cycling. As we grow and develop more experience, I can only expect to develop a cooperative environment for all the parties to work together.

Ferren: How does the budget for ACE work? Are you fully funded by the non-profit Cycling Ethics Foundation? Does ACE pay for the testing or do the teams pay a portion? How can cycling fans get involved?

Dr. Paul Strauss: We receive funding both through the generous donations of the non-profit Cycling Ethics Foundation as well as corporate funding of programs directly through ACE.

In the interest of removing any potential internal influence in the ACE anti-doping program, the funding for the testing will come from sponsors into ACE and be independent of the teams. As more financial resources become available, to the best of our abilities, they are not designated to a particular team. In our startup phase, some anticipated funding did not materialize on scheduled and for Team Slipstream, funding from the organization is being used as a bridge until other funding arrives.

Ferren: I'm interested in ACE's education efforts. What counseling services will be offered to riders? Other than protecting the riders' health, there seems to be nothing so important as alleviating the antagonistic feelings many riders have toward the anti-doping process and making them understand how important it is to show the public that cycling is pointed toward a cleaner future.

Dr. Paul Strauss: Part of the problem is the cycling environment in which these athletes compete, they don’t understand the health risks of these medications. The current punitive system places riders in an antagonistic position to the testing agencies. In ACE we bring the rider and the team into the process. Professional athletes need to be reminded at times that they are role models for the amateur racers and the general public. People emulate the professional cyclist’s behaviors and real medical issues do occur such as liver and kidney failure, and even death in ordinary athletes. I have personally seen this and taken given care of patients who have abused steroids and EPO. Our education and counseling programs are meant to change this.

Ferren: Former US Postal rider Frankie Andreu is a member of the ACE Board of Advisors. How did Frankie become involved with the project? What is his role? He recently admitted to using the blood booster EPO before the 1999 Tour de France. Does his admission have significance for ACE?

Dr. Paul Strauss: Frankie originally was contacted through a personal relationship. However he has very strong personal feelings against doping in cycling; that was why he expressed his feelings to the public. Frankie's personal beliefs and ACE's mission are 100 percent aligned.

Ferren:  Is there anything else you would like the public to know about ACE?

Dr. Paul Strauss: ACE was started by two local California amateur racers who are very disturbed by the negative public perception of the sport we love as well as doping by riders we were racing with. Whether it is true that some or all professional and amateur cyclists are doping or there is just a perception of doping does not matter, it is destroying our sport. We need and feel we will be able to make a difference with ACE.

Ferren: I have a question about making the test results available to WADA or ADA. Will that be strictly the prerogative of the rider or teams? Is there any way that WADA could obtain the results and use them to bring an action against a rider?

Dr. Paul Strauss: It is up to the team who they want to share the data, but in the effort of maintaining transparency in the program, the teams have expressed no problem with sharing the data which we strongly support.

In so much as this is new territory in the world of anti-doping, discussions of joint research between ACE and WADA are being held.

You have to remember that biomarkers only suggest the possibility of doping which will result in further testing and bringing the athlete into the process. An action by WADA could not be brought directly against an athlete from changes in biomarkers with the current state of knowledge.

Ferren: Do you plan to publish on your website an ethical guideline for the teams enrolled in ACE?

Dr. Paul Strauss: As our program develops and the ACE community grows, all of our ethical guidelines will be shared. Again all to maintain transparency of the program.

Ferren:  One non-ACE related question for Paul Scott. If he's not familiar with the issue there's no need for him to answer the question. Floyd Landis claims that his IRMS sample wouldn't have been positive if the results were interpreted by the UCLA lab. Could you speak to the differences in positivity criteria among the WADA certified labs? Is this an issue in your opinion that needs to be addressed?

Dr. Paul Strauss: We can not comment on any specific and pending cases. However the judicial system has been set up because the science is not infallible in this human process.

Once again, Paul thanks.
More information: Agency for Cycling Ethics