“It’s Dead Serious” — Inside Kenya’s Recent Doping Epidemic – LetsRun.com

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By Jonathan Gault
January 6, 2023

It was the best of times, it was the worst of times.

2022 was a very successful year for Kenyan marathoners. Last year, Kenyan men won all six World Marathon Majors, with Kenyan women adding another four victories in Tokyo, Boston, Chicago, and New York. Some of those performances were among the fastest in marathon history, headlined by Eliud Kipchoge‘s 2:01:09 world record in Berlin and Ruth Chepngetich‘s 2:14:18 in Chicago, which missed the world record by 14 seconds.

Yet as Kenyans broke records on the roads, they were also suspended from competition at an alarming rate. No fewer than 25 Kenyan athletes were suspended by the Athletics Integrity Unit (AIU) or the Anti-Doping Agency of Kenya (ADAK) in 2022.

The list of banned athletes includes some major names.

On July 16, the day before he was set to contest the World Championship marathon in Eugene, 2019 Boston and Chicago Marathon champion Lawrence Cherono was provisionally suspended for testing positive for the banned heart medication trimetazidine.

On October 14, the AIU announced Diana Kipyokei, the 2021 Boston Marathon champion, had failed an in-competition drug test at that race. On December 20, the AIU upheld her ban and the Boston Athletic Association stripped Kipyokei of her title.

Then on October 20, the AIU announced it had banned Marius Kipserem, a 2:04 marathoner and winner of big-city marathons in Abu Dhabi and Rotterdam, after he admitted to taking EPO. He was the fifth Kenyan to be suspended by the AIU that week.

What is going on in Kenya?

That is the question on the minds of athletes, fans, journalists, and anyone with a stake in the sport of distance running as 2023 begins. To get an answer, LetsRun.com reached out to Brett Clothier, head of the AIU, along with agents, elite athlete coordinators at major road races, and a top coach who works with Kenyan athletes. Here’s what we learned.

“They have a really big doping problem”

Doping in Kenya is not a new issue. A WADA report revealed that 131 Kenyan distance runners tested positive for prohibited substances between 2004 and 2018. In 2018, when World Athletics introduced categories for national federations’ level of doping risk, Kenya was one of four federations included in Category A — those at highest risk of doping. Five years later, it remains on that list.

“They have a really big doping problem that we need to address,” Clothier says. “It’s dead serious.”

Kenya is better-positioned to fight doping than it was a decade ago. The country did not even have a national anti-doping agency until 2016, but Clothier says that ADAK has been a “willing, valuable partner” for the AIU in recent years.

Among the conclusions of the 2018 WADA report was that “athletes in Kenya are insufficiently educated on doping and/or willfully blind as to the consequences of doping.” ADAK and Athletics Kenya have tackled that issue by staging anti-doping seminars to educate athletes, yet the problem of doping in Kenya persists.

Financial crunch of COVID and better testing intelligence = increase in cases

Clothier believes there are a few reasons that have led to the spike in Kenyan cases, though he points out some cases announced in 2022 were a long time in the making. Kipyokei, for example, tested positive in October 2021 but was not suspended until over a year later.

One reason for the increased number of cases, Clothier says, is the financial stress of the COVID pandemic. In 2020 and 2021, there were fewer opportunities for athletes to earn prize money and appearance fees at road races. So when athletes did resume racing, the pressure was on to ensure they came home with something.

Several agents echoed that explanation to LetsRun.com.

“Probably the athletes, like all the populations, suffered financially and they were looking more than ever for shortcut to make money,” says Federico Rosa, an agent who represents a number of top Kenyan athletes.

Clothier also says there have been more cases because the AIU is getting better at catching cheaters.

“This is more of an evolutionary thing over time,” Clothier says. “AIU’s been in place since 2017, and as each year goes by, we’re getting better and better at understanding the doping situation in Kenya and being able to uncover doping. It’s not a magic button that’s been flicked to change things…We’re definitely collaborating better with ADAK as well, and this is contributing to the uptick in cases.

“It’s really understanding the environment in Kenya better, understanding the local factors. As time’s gone on at the AIU, we’ve built our capability to be testing the right athletes at exactly the right time for exactly the right substance.”

One more factor that cannot be ignored: the AIU conducts more tests on Kenyan athletes than any other nation, by far, as shown by the chart below.

Out-of-competition and in-competition tests conducted by the AIU in 2021 (top eight countries)

Country	Tests	Percentage of whole
Kenya	1,319	18.56%
Ethiopia	931	13.10%
USA	584	8.22%
China	266	3.74%
Great Britain	194	2.73%
Spain	187	2.63%
Poland	180	2.53%
Jamaica	145	2.04%

Data courtesy AIU

That disparity in testing is due in part to the AIU’s Road Running Integrity Programme, begun in 2019 after a study found that 76% of winners at IAAF Gold Label road races were not part of an out-of-competition testing pool.

Typically, the AIU tests the top 10 athletes in the world in each track & field event, with national anti-doping agencies responsible for athletes who fall outside that criteria. In road racing, however, there is far more prize money available to athletes ranked outside of the top 10 in the world.

“These athletes were not in any of our pools,” Clothier says. “80% of them are from Kenya and Ethiopia. So there are too many of them normally for the national anti-doping agencies of those countries to handle.”

The solution, developed jointly by World Athletics and the AIU, was to expand the AIU testing pool to include the top 300 road athletes, a move that would cost $3 million per year, jointly funded by World Athletics, the AIU, agents, and major road races. Under the terms laid out by World Athletics, races would contribute between $2,500 and $66,667 annually, depending on the size of the event. Agents would pay $500 for each gold-level athlete they represent and $1,000 for each platinum-level.

Clothier applauded the races for their contributions and said that while the pandemic prevented the AIU from implementing the full plan — they asked for only $1.5 million the last two years given the financial stress of COVID — the expanded testing scheme is now paying dividends.

“Since 2020, we’ve had that extra $1.5 million a year to put into road running testing and intelligence and investigations and that’s played a huge part in us getting better and better and being able to do this well,” Clothier says. “It’s also played a huge part in having an increased focus in Kenya as opposed to other places. The good news is that from next year, that funding looks set to really increase again and go back up towards the $3 million mark that was originally intended.”

While the extra funds have led to more doping busts and a cleaner sport, the spate of positive tests in Kenya has created a headache for those tasked with selecting elite fields for the world’s top races. It is not practical — or fair to the clean Kenyan athletes — to stop inviting Kenyans to their races. But no one wants to be in the position a race like Boston currently finds itself, with one recent champion busted (Cherono) and another stripped of her title (Kipyokei).

Mary Kate Shea, the B.A.A.’s elite athlete coordinator responsible for recruiting the Boston Marathon field, said Boston shares its field with the AIU ahead of the race to “provide additional opportunities for out-of-competition testing and oversight.” She said Boston’s aim is “to be diligent about recruiting athletes who have been tested or are in testing pools for all countries. The agents and athletes we work with know this is the precedent.”

Marc Roig, elite athlete coordinator for the Valencia Marathon, said that Valencia, like the World Marathon Majors, does not invite athletes who have served doping bans to compete in their races. While it is impossible for anyone to know definitively whether any athlete is clean, Roig says he believes it is his duty to be proactive when assembling Valencia’s elite fields.

“Of course, we are concerned about the doping cases among Kenyan athletes and we do our best to be able to celebrate the results that we achieve,” Roig says. “I am not perfect when selecting the athletes that will compete in Valencia, but I do my own research before I sign an athlete.”

What about Ethiopia?

If COVID-related financial pressures and expanded out-of-competition testing for road athletes are driving the rise in Kenyan cases, then why haven’t we seen the same trend in Ethiopia? Like Kenya, many of Ethiopia’s top athletes turn to running to escape poverty, with the majority competing on the roads. Yet in 2022, the AIU only announced two doping cases involving Ethiopians.

One theory about Ethiopia’s small amount of positives is that the country’s bloody civil war could have inhibited testing. But while Clothier says it has become harder to test in some areas, he does not believe testing access to be a major issue.

“Generally speaking, we’ve got no problem testing in Ethiopia,” Clothier says. “We do a lot of testing in Ethiopia.”

Rosa says that, in general, he receives better communication from his Ethiopian athletes when they need to take medication. Ethiopia is also different when it comes to where athletes train.

“Athletics in Ethiopia happens all in Addis [Ababa], so there is more control and more access to federation doctors than in Kenya, where many athletes live and train in very rural places far from facilities,” Rosa says.

Clothier says he isn’t certain why Kenya has had so many more cases than Ethiopia. All he knows is that there is a disparity.

“They’re neighbors in East Africa but completely different countries,” Clothier says. “We shouldn’t just expect one to be the same as the other.”

Based on the number of elite athletes coming from each country, one would expect there to be fewer positives in Ethiopia than Kenya — but not 10 times fewer. Even though Ethiopia has a population of more than twice the size of Kenya (118 million vs 55 million in 2021), Ethiopia has always produced fewer elites than Kenya. Per World Athletics Stats Zone, 526 Kenyans had broken 2:10 in the marathon as of December 21 compared to just 239 Ethiopians (of course some of that discrepancy could be due to doping).

Why triamcinolone acetonide?

While norandrosterone (aka nandrolone — the same substance Shelby Houlihan was banned for) is the drug to have featured in the most number of Kenyan cases this year — 10 of the 25 athletes were banned for it — it is a different drug, triamcinolone acetonide, that has been making headlines. That’s in part because it is the substance Boston winner Diana Kipyokei tested positive for, and in part because the AIU sent out a detailed press release about the drug and its prevalence — an uncommon move that served to raise the alarm globally. Over the last two years, the AIU says, 10 Kenyans have tested positive for triamcinolone acetonide in-competition compared to just two positive tests for the rest of the world combined in that span and only three positive tests in Kenya from 2017-20.

Not all of those positive tests have resulted in bans, because triamcinolone acetonide is legal out of competition and in-competition when inhaled or applied as a cream. In fact, so far only three athletes — Kipyokei, Betty Wilson Lempus and mountain runner Mark Kangogo — have been banned for their use of the drug. But four more cases involving triamcinolone acetonide remain under investigation by the AIU, with two cases pending with ADAK.

List of Kenyans sanctioned for anti-doping rules violations in 2022

Athlete	Substance/offense
Ibrahim Mukunga Wachira	Norandrosterone
Keneth Kiprop Renju	Methasterone
Diana Chemtai Kipyokei	Triamcinolone acetonide, tampering
Betty Wilson Lempus	Triamcinolone acetonide, tampering
Michael Kunyunga Njenga	Norandrosterone
Maiyo Johnstone Kibet	EPO
Lawrence Cherono	Trimetazidine
Eglay Nafuna Nalyanya	Norandrosterone
Marius Kipserem	EPO
Mark Kangogo	Norandrosterone, triamcinolone acetonide
Philemon Kacheran Lokedi	Testosterone
Felix Kipchumba Korir	Norandrosterone
Emmanuel Saina	Norandrosterone
Lilian Kasait Rengeruk	Letrozole
Vane Nyaboke Nyanamba	Norandrosterone, tampering
Tabitha Gichia Wambui	Norandrosterone, tampering
Joel Maina Mwangi	Nandrolone
Mathew Kipkoech Kisorio	Whereabouts failures
Justus Kimutai	Whereabouts failures
Morris Munene Gachanga	Whereabouts failures
Edward Kibet Kiprop	Nandrolone
Paul Kipchumba Lonyangata	Furosemide
Alice Jepkemboi Kimutai	Testosterone
Purity Rionoripo	Furosemide
Mike Kipruto	Unknown

Triamcinolone acetonide is a steroid, specifically a glucocorticoid, and has legitimate medical uses. As a cream, it can be used to treat certain skin conditions, while as an injection, it can reduce inflammation in joints. But it also has the potential to be abused. It can help athletes lose weight without sacrificing power, and Clothier says it can produce a euphoric effect in competition and training. Triamcinolone acetonide was a popular drug of abuse among professional cyclists in the 2000s and 2010s.

“I could well see how a week or two of that a year, at the right time, would allow an endurance athlete to train 5% harder, 10% longer, get that benefit, and then come off it, probably also a bit lighter with less body fat, and parlay that combination of training and body composition into performance 2 to 3% better,” sports scientist Ross Tucker wrote in an email to LetsRun.com. “And you know that over a marathon, 2% is 2 to 3 minutes. Huge benefit. 8th to 1st kind of stuff.”

So why is it only becoming popular in Kenya now?

“We’ve been catching more and more Kenyan athletes doping over the last few years with substances like EPO, through the ABP (Athlete Biological Passport) program, or steroids, etc.,” Clothier says. “And I think — and I’m saying this as a general comment based on the statistics we’ve seen — is that it seems that they’ve moved to using this substance and these sort of methods to avoid detection for doping, similar to the way cyclists have used this substance in the past hoping to be able to use it to gain a performance edge. Albeit less of one than something like EPO or a steroid. They have thought they will be able to avoid any penalty because they would be able to get a therapeutic use exemption (TUE). That’s kind of the working assumption.”

The risk of getting caught is lower for triamcinolone acetonide than for most performance-enhancing drugs, because the substance is not banned out of competition and because it is easier to acquire a phony prescription or TUE. An elite athlete is unlikely to be prescribed EPO under any circumstances, but doctors can and do prescribe triamcinolone acetonide to treat injuries.

Embed from Getty Images

Triamcinolone acetonide is only part of the problem, however. One agent, who requested anonymity in order to speak freely, was alarmed by the number of high-profile athletes testing positive for “old school” drugs long known as illegal and detectable in out-of-competition testing such as nandrolone and EPO. With an up-and-coming athlete, the agent says, it could at least be understandable, but he says it makes no sense for established athletes such as Marius Kipserem and Emmanuel Saina.

“Imagine if somebody gets to a certain level by doping and now he or she earns a $50,000 contract,” the agent says. “With an appearance for some big marathon, another $20,000 – $30,000, now suddenly you have $80,000 and you’re coming from zero. If you got there with doping, then logical thing would be to stop doping. Because you arrived – you’re not poor anymore…

“Why would an athlete who is in a testing pool be injecting something that is easily detectable like nandrolone? That really confuses me…If you are testing people a lot, that should actually deter doping.”

Rosa, who represents both Kipserem and Saina, says he knew nothing about their positive tests until he found out on social media.

“Marius and Saina, they both train in Kapsabet with Lawrence Saina as coach,” Rosa says. “Emmanuel didn’t stay much in the camp in this period [to] try to recover from an injury. We shut down the camp and fired the coach right away to try to understand more and to take a strong position against their behavior.”

Who is responsible?

When an athlete in Kenya tests positive, the first questions the AIU seek to answer are where did the banned substance come from, and how was it acquired. They are questions that have remained frustratingly difficult to answer. Many athletes are unwilling to share their supplier, even when offered the reward of a lighter sanction. That has also made it difficult to figure out who, exactly, is to blame for Kenya’s doping epidemic.

The athletes, of course, are the ones who bear final responsibility for the substances in their bodies. But Clothier says no two doping cases are alike.

“Sometimes the networks are organized but sometimes it’s not a particularly organized enterprise,” Clothier says. “There’s a thriving black market, unfortunately, for performance-enhancing drugs. You think of all the people who could be around an athlete when we talk about networks. It could be medical professionals involved, there could be athlete support persons involved as well as the athletes themselves.”

One agent divides the dopers into two main groups: those who seek out an edge, and those who are enticed to dope, knowingly or not, by a third party such as a coach, agent, or doctor. A top coach based in Kenya told LetsRun he viewed the situation similarly, noting that younger athletes with less access to education are prime targets.

“Some athletes, they come from poor backgrounds, maybe they didn’t have a chance to finish school and they don’t understand the dynamics of the sport,” said the coach, who asked not to be named. “So there are people that they put in their minds that ‘[Doping] is the way to do [it]. That’s normal. Everybody does that.’”

Who are these people convincing athletes to dope? The coach believes they are “brokers” — people who can connect athletes with doctors willing to provide them with illicit substances in return for a cut of the athlete’s earnings.

“I personally don’t think they are agents,” the coach says. “Of course there are doctors. But between maybe doctors and athletes, there are brokers…I’m sure it’s a matter of money. It’s a business for them.”

Some have argued the AIU has not gone after agents strongly enough. If an agent represents too many athletes who have been banned, the logic goes, that agent is either complicit or negligent. The agents LetsRun spoke to pushed back on that argument.

“In Western media, it’s very simple,” says one agent. “Athlete tests positive – ah, [the] agent supplied [them]! It’s an agent problem. That worries me. Because people don’t understand Kenya and Ethiopia and all these countries, it’s many people around the athlete that you can’t actually exclude from the athlete…I really don’t think agents are supplying doping. Maybe some agents are less observant or less interested. Maybe some agents believe it’s not my job to do this, my job is to bring the athlete to the marketplace.”

Rosa, who in addition to Saina and Kipserem has also represented banned dopers such as Lawrence Cherono, Rita Jeptoo, and Jemima Sumgong, says his company has had “ongoing discussions” with its younger clients about the consequences of doping.

“We tried to fight the problem but is not an easy one,” Rosa says. “…With the athletes we are very straight, and we keep explain[ing] and push them that in case of any physical problem, they need to inform us or the doctors of federation, and send us the picture or the correct name of the medicine they locally told them to use before they take, so we are very frustrate[d] when results come back positive.”

The anonymous agent says it would be irresponsible to label Kenya’s doping as a problem solely with agents or a problem solely with athletes, but says it is crucial to learn more from athletes who are banned. No athlete should be allowed to have their sanction reduced without providing information about the source of the drugs, the agent says.

“There is no one person to blame,” the agent says. “The athlete is always in the center because substance is in his or her body. If that person doesn’t speak, what can we learn? Nothing. How do we motivate that person to speak about supply chain, how this entered the body and who are the people along the way? AIU really should look into this and figure out better ways that actually will get to the source of the problem and not just the end user.”

Clothier says the AIU is determined to prosecute “any athlete support persons who are under our jurisdiction.” Because there is no single source of drugs, it’s not possible to eradicate doping in one fell swoop. But with every case they make, Clothier says, the AIU is learning more and coming closer to identifying the individuals at the center of Kenyan doping circles.

“In Kenya, the doping is reaching a higher level of sophistication than it has in the past,” Clothier says. “There’s certainly not a centralized system, but there are networks of people working together — so essentially, a criminal enterprise. There’s a lot of money to be made, on the road especially, and people are working together to get the money. Those networks, they probably realize that the net is starting to tighten around them.”

How can this be fixed?

Kenya and the AIU have taken steps to solve its doping problem, which has left many stakeholders frustrated that the country’s issues persist despite wider testing and the introduction of an anti-doping agency. The number of cases demonstrates that cheaters are getting caught — but the frequency of cases remains high. Clearly, there is no easy fix but the agents and Clothier offered a few ideas to LetsRun.com.

Gianni Demadonna, who represented Kipyokei and Lempus, both of whom were suspended last year, suggested bigger threats for those helping athletes to dope. Under Kenyan law, athlete support staff can be jailed for up to three years for connections to doping, though that provision has rarely been utilized.

“Why are these athletes not saying the truth to the AIU?” Demadonna says. “Make the names of the doctors. Try to put in prison these doctors.”

One agent suggested increasing the level of accountability in the sport, either by asking athletes and agencies to agree to a “no-needle” policy similar to the one adopted by cycling’s governing body in 2011 or by adding addendums to the contracts athletes sign with races that heighten the stakes of a positive test.

“Imagine if a race makes you sign an affidavit – if I have this-and-this substance in my system, I am liable this amount of money to that race,” the agent says.

That agent also believes that if the AIU is to really attack the problem of doping, it must commit a larger share of resources to investigations and intelligence. The Road Running Integrity Programme had a budget of $1,375,656 in 2021. Of that total, the AIU spent $20,908 (1.5%) on investigations and intelligence and $748,040 (54.4%) on testing. Of the AIU’s $8,809,362 overall budget for 2021, $123,454 (1.4%) went to investigations and intelligence and $3,401,089 (38.6%) to testing.

“Talking to people who work in law enforcement who understand a bit about drugs and these kind of things, they all tell me that these kind of drugs are more intelligence-driven than just dirty police work,” the agent says. “It’s one of my questions to ask Brett, when we meet him in New York as agents: how do we go $750,000 in testing and $20,000 in intelligence? It’s a very small number.”

Another agent noted that the open nature of road running and track & field makes it difficult to stay on top of every athlete. In sports like cycling, baseball, or football, it’s easy to divide the professionals from the amateurs. In running, it’s different.

“Whether they come straight from a village in Kenya or they walk into the professional sport from the NCAA, we don’t know anything about them in terms of testing,” the agent says. “…Anyone can walk straight into a Diamond League if given a chance…How do we police that?

“…The biggest solution — but this is for the whole world — is if we have a real professional sport where athletes are really part of something and also everybody has rights and obligations. And then you limit the number of people who are part of that professional sport, and that is easier to police. And then if people want to be part of that professional sport, you go through a certain system like in tennis or golf where, once you’re at the top-tier events you have gone already through some years of good testing…It’s very hard because then how many athletes do you allow to be part of the professional sport?”

“They certainly don’t have a free pass forever. Changes need to be made”

The AIU has taken steps to that effect through the Road Running Integrity Programme and the requirement of athletes from high-risk federations like Kenya to undergo three out-of-competition tests in a 10-month period in order to participate at World Championships and Olympic Games. And even if there were some sort of hard boundary to participation in professional running, there’s no guarantee the sport would be cleaner. A number of the recent Kenyan doping cases involved established athletes.

The heaviest possible sanction is a blanket ban — a suspension of the Kenyan federation and all of its athletes from international competition until Kenya can put its house in order. It’s a move the World Athletics Council used on Russia, whose federation has been suspended since 2015. But the World Athletics Council chose not to suspend the Kenyan federation at its most recent meeting in Rome on November 30. And for good reason.

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“A key difference between the Russian federation and the Kenyan federation is that in Kenya, we have the authorities who are actively working with us and cooperating with us to uncover doping,” Clothier says. “That’s the case with Athletics Kenya and the Anti-Doping Agency of Kenya. In Russia, it was the opposite situation. The authorities there were working against the AIU.”

To do their job properly, however, Clothier says both AK and ADAK require more funding, which is now on the way. In November, the Kenyan government committed an extra $5 million per year for the next five years toward bolstering anti-doping efforts in the country. As a result, a blanket ban on Kenyan athletes is unlikely in the near future. But that could change if the situation does not improve within a few years.

“Even if they’re trying their best, they certainly don’t have a free pass forever,” Clothier says. “Changes need to be made in the system and I’m sure the World Athletics Council will be looking closely at that. What I am sure about is they’ll get a chance [to address it] given the cooperation we’re getting.”

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