Concerns Over Use of African Herbs During the 2010 World Cup

This June, the games of the 2010 World Cup will begin in South Africa—which will mark the first time an African nation has hosted the tournament in its 80-year history. Held every 4 years and watched by billions, the World Cup is the “world championship” of football (soccer)* and is governed by the Fédération Internationale de Football Association (FIFA).¹

In February of 2010, FIFA officials expressed concerns that some African herbs might enhance World Cup players’ performance, thus providing them with an unfair advantage over other competitors.² At a pre-World Cup medical workshop, South African doctors informed FIFA’s medical committee that some African plants could potentially boost players’ energy, help heal their muscles at a faster speed, or provide them with other stimulant and diuretic benefits.

FIFA officials and team doctors have suggested that the use of some botanicals might go undetected by tests currently used in laboratories accredited by the World Anti-Doping Agency (WADA), an international and independent organization responsible for sports-related anti-doping activities like standards-setting, testing, and scientific research.³ They have also mentioned that some plants might produce byproducts that are not currently included on WADA’s list of banned substances.² Botanical or botanical-related substances currently on this list are ephedrine (from Ephedra spp., Ephedraceae), cannabis (Cannabis sativa, Cannabaceae), and cocaine (from coca; Erythroxylum coca, Erythroxylaceae).⁴

Still, according to Jiri Dvorak, MD, a member of FIFA’s medical committee, FIFA has “absolutely no indication that players are using herbal medicines to enhance their performance” (oral communication, March 10, 2010). FIFA has held open discussions with the physicians of all teams and has received written support for the anti-doping declaration from all teams, said Dr. Dvorak. He additionally noted that the sport of soccer has a low incidence of positive doping tests, such as 0.42% in 2004 and 0.37% in 2005.⁵

Dr. Dvorak said that FIFA is undertaking a long-term strategy that will primarily focus on educational outreach. (FIFA’s responsibilities do not include doping-related research and testing; such activities fall within WADA’s domain.) FIFA is informing team physicians that they need to ensure that their players are aware of botanical substances that might result in positive doping tests, because they are ultimately responsible for what their players put into their bodies, said Dr. Dvorak.

FIFA has expressed its concerns to WADA, and WADA has been encouraging transnational programs that focus on traditional medicine usage. WADA can fund such programs as part of its science research grant program, according to Frédéric Donzé, WADA’s senior manager of media relations (e-mail, March 9, 2010). WADA is also encouraging local entities to address the issue by conducting more research and properly educating their athletes on the risks associated with traditional medicine usage possibly resulting in positive doping results.

“This matter is one that is more efficiently addressed by national and local sports and anti-doping authorities that know the specificities of each region or country in terms of traditional medicines,” said Donzé.

While difficult for sports organizations to identify and ban any poorly-known performance-enhancing substance, doing this with herbs can be even more complex, said Nigel Gericke, MD, a physician and botanist in South Africa (e-mail, March 14, 2010).

“The chemistry and pharmacology of many of the functional foods and medicinal plants of the world are not at all well-researched, and the net effect of complex polymolecular substances on sports performance is even less understood,” said Dr. Gericke. “FIFA faces a monumental challenge to begin to understand the chemistry and pharmacology of polymolecular substances, and one would hope that FIFA, along with other global sporting bodies, will contribute ongoing funding for relevant analytical, pharmacological, and clinical research in the interests of enhancing and optimizing the well-being of sportspeople, and in the interests of fair competition in sport.

“As more analytical and pharmacological research is conducted on the functional foods and herbal remedies of the world, one can anticipate more substances to be added to the banned substances list,” Dr. Gericke continued.

Concerns over herbal medicine usage during international sporting events are not new. During the 2008 Beijing Summer Olympics, for example, several news organizations reported that the Olympic organizing committee decided to not use herbal Traditional Chinese Medicine (TCM) to treat Olympic athletes in order to avoid potential doping problems.^6,7,8

Additionally, the committee released a list of remedies containing banned substances 3 years before the Olympic Games began and updated this list in December of 2007. Included on the list were deer penis, turtle blood, and remedies made from the root of dong quai, or Chinese angelica (Angelica sinensis, Apiaceae). In May of 2008, China’s State Food and Drug Administration required manufacturers of traditional medicines to include athlete caution statements on many products’ labels, and Olympic officials also advised Chinese athletes to abstain from taking traditional herbal remedies. The media, however, reported that many athletes continued to use herbal remedies during the events, though no official research was conducted to document this and Chinese coaches claimed that most remedies had been replaced by protein and vitamin supplements.

From the moment in 2004 when FIFA announced South Africa as the location of the 2010 World Cup,⁹ some began questioning the country’s ability to handle the safety, logistical, and infrastructure issues associated with the event. Others argued that such speculation represented a bias against the African nation, and that FIFA’s concerns over African medicinal plants discriminate against South Africa’s non-Western customs.¹⁰ But Dr. Dvorak disagrees.

“We don’t see this as a discrimination at all,” he said. “It has been brought up by the South African people. It is not FIFA discriminating against anybody—it is just an issue to discuss.” Dr. Dvorak added that FIFA is aware that the use of herbal medicines is not an Africanspecific situation.

—Lindsay Stafford

References

1. The history of the FIFA World Cup. Fédération Internationale de Football Association website. Available at: www.fifa.com/classicfootball/history/ worldcup/index.html. Accessed March 24, 2010.
2. AP interview: FIFA concern over African stimulants. Associated Press. February 21, 2010. Available at: www.dallasnews.com/sharedcontent/dws/spt/ moresports/stories/022210dnspo_fifadoping.3e26356.html. Accessed March 8, 2010.
3. About WADA. World Anti-Doping Agency website. Available at: www.wada-ama.org/en/About-WADA/. Accessed March 25, 2010.
4. World Anti-Doping Agency. The World Anti-Doping Code. The 2010 Prohibited List: International Standard. September 19, 2009. Available at: www.wada-ama.org/Documents/World_Anti-Doping_Program/WADP-Prohibited-list/WADA_Prohibited_List_2010_EN.pdf. Accessed March 25, 2010.
5. FIFA’s approach to doping in football. Fédération Internationale de Football Association website. Available at: http://img.fifa.com/aboutfifa/federation/ news/newsid=514055.html#fifas+approach+doping+football. Accessed March 24, 2010.
6. No herbal medicine at Beijing Olympics. Xinhua News Agency. December 9, 2007: National News. Available at: http://lanzhou.china.com.cn/english/China/234898.htm. Accessed March 9, 2010.
7. Page J. Traditional Chinese medicine could be a recipe for failure at Olympics. The Times. July 1, 2008: Overseas News. Available at: www.timesonline. co.uk/tol/sport/olympics/article4245002.ece. Accessed March 9, 2010.
8. Cheng W. Deer penis loses favor as Chinese Olympians fear drug testers. Bloomberg. April 1, 2008. Available at: www.bloomberg.com/apps/news?pid= 20601109&sid=aCQ0IoTLiM.4&refer=home. Accessed March 9, 2010.
9. Singing South Africa’s praises [press release]. Zurich, Switzerland: Fédération Internationale de Football Association; February 24, 2010. Available at: www.fifa.com/worldcup/news/newsid=1173450.html#singing+south+africas+praises. Accessed March 8, 2010.
10. Khumalo F. Fifa has no hope against the muti magic. Times Live. February 28, 1010. Available at: www.timeslive.co.za/opinion/columnists/article329401.ece. Accessed March 25, 2010.