On July 3, 2023, Athletics Illustrated published an article that the Athletics Integrity Unit was investigating Kenyan runner Titus Ekiru and may suspend him for up to 10 years, effectively ending his career.

The sixth-fastest (now seventh) marathon runner of all time Kenyan Titus Ekiru faces a possible 10-year doping and tampering ban according to the Athletics Integrity Unit.

Ekiru has been charged with four Anti-Doping Rule Violations (ADRVs). Two separate charges relating to the detection of prohibited substances in his samples and two separate tampering charges regarding the results-management process in each case. Monday, it had been confirmed in a press release by the Athletics Integrity Unit.

Press Release from the AIU

The Athletics Integrity Unit (AIU) has banned elite marathoner Titus Ekiru for ten years, in a case exposing collusion with a high-ranking doctor at a Kenyan hospital.

This sanction follows a comprehensive investigation which revealed Tampering by the 31-year-old to obstruct the AIU’s probe into two Adverse Analytical Findings (AAFs), using “false/misleading information and documentation”. Ekiru tested positive twice for the Presence of Prohibited Substances, or their metabolites or markers, in his in-competition urine samples at marathons that he won in 2021: the Generali Milano Marathon on 16 May 2021 (triamcinolone acetonide) and the Abu Dhabi Marathon on 26 November 2021 (pethidine and its marker norpethidine). In addition to the ban – which runs from 28 June 2022 (the date of Ekiru’s provisional suspension) until 27 June 2032 – Ekiru’s results on and since 16 May 2021 have been disqualified, resulting in the forfeiture of all prizes and money. Ekiru’s victory in the Generali Milano Marathon would have made him the sixth-fastest marathoner of all time.

In July 2023, he was charged with two counts of the Presence of a Prohibited Substance, as per Rule 2.1 of the of the World Athletics Anti-Doping Rules (ADR), and two counts of Tampering or Attempted Tampering with any part of Doping Control (ADR Rule 2.5). Initially, Ekiru signalled his intention to contest the charges. However, faced with substantial evidence against him, the Kenyan athlete decided that he no longer wanted to pursue the case.

As a result, the AIU requested the termination of the disciplinary proceedings that had been instigated before the Disciplinary Tribunal and issued a decision in the case, treating the two Presence charges and the first Tampering or Attempted Tampering charge as a single Anti-Doping Rule Violation (ADRV). In this regard, the period of ineligibility is based on the violation that carries the more severe sanction – four years for the Rule 2.5 (Tampering) violation – plus two years for Aggravating Circumstances, totalling six years. Another mandatory four-year sanction has been imposed for the second Tampering violation committed by Ekiru in connection with his explanation for the second Adverse Analytical Finding (AAF), which is to be served consecutively to the six-year period for the two Presence charges and the First Tampering or Attempted Tampering Charge, thereby totalling ten years’ ineligibility.

AIU Chair David Howman today revealed the full details of the case

Enlisting assistance from the Anti-Doping Agency of Kenya (ADAK), the AIU acquired hospital information which showed discrepancies in Ekiru’s explanations and supporting documentation for the AAFs which he contended stemmed from prescribed medications for injury treatments. Deeper investigation unearthed Ekiru’s collusion with a senior doctor in Nandi County from whom, on two occasions (29 April 2021 and 6 May 2021), the athlete received injections of triamcinolone acetonide during undocumented hospital visits. In relation to the second AAF, there was a third undocumented hospital treatment on 19 November 2021, during which Ekiru received a pethidine injection and meperidine (pethidine) tablets (among other medication) for acute pain. The senior doctor claimed Ekiru’s visits were unrecorded by the hospital as “the athlete had attended early in the morning, before the registration offices had opened”. Ekiru said he received an outpatient number and card on his first visit on 29 April which he subsequently used on his second visit (6 May), but hospital documents obtained by the AIU revealed that the outpatient number was not issued to Ekiru until 16 June 2021; the one occasion on which the hospital confirmed Ekiru’s attendance as an outpatient.

It was testimony of the Nandi County Director of Medical Services which solidified the case against Ekiru with a series of damning conclusions – while also exposing the complicity of the senior doctor. These included that, given the outpatient number assigned to Ekiru was not issued until 16 June 2021, any medical documents for his alleged treatment on 29 April 2021 and 6 May 2021 were produced on or after 16 June 2021 and were back-dated, that the hospital in question had never stocked triamcinolone acetonide or meperidine tablets (the latter never having been purchased by the County Government for distribution to any hospital in the County), that the hospital Pharmacy Registers showed that no triamcinolone acetonide or pethidine had been dispensed on the relevant dates and that the hospital Injection Register had been manipulated to include a reference to an injection of pethidine given to Ekiru on 19 November 2021. The Nandi County Director of Medical Services therefore concluded that Ekiru’s medical documents submitted to the AIU to explain his AAFs were forged and were inconsistent with the hospital records.

“The outcome in this case is testimony to the collaboration between the AIU and ADAK, but even more so to the important co-operation from the most senior medical official of the Nandi County Government who provided significant evidence needed to ascertain the truth in this case and uncover the complicity of a senior doctor working in one of the County hospitals,” noted Howman.

“Government officials are now working alongside ADAK and the AIU to uncover doping in Kenyan athletics and expose the networks that may be involved. For athletes involved in doping and the entourage who assist them, there is one strong message from this case – there is nowhere to hide.”

The AIU has formally requested that ADAK refer the conduct of the senior doctor to the criminal authorities in Kenya for further investigation.