Olympians given food for thought
Written by: Matthew Staff
So, the Rio de Janeiro Olympics and Paralympics are only about three years and 11 months away, and with the next installment of sporting greatness already on the horizon, planning begins now for the thousands of budding athletes around the world dreaming of future gold medals.
Jogging around the parks, swimming the lanes and cycling the roads may take care of the technical aspects, but there is one side of sporting preparation that simmers quietly in the background at all times for an elite athlete.
Olympians and Paralympians are expected to stick to tailor-made diets for their specific discipline, requirements and body shape at all times in order to excel when the all important time comes in the heat of battle, and sports nutrition has become one of the biggest buzz words in the modern sporting era.
Enabling the enhancement of physical performances across all sports, the intake of certain foods and drinks are critical in not only defining the sporting body, but also breaching social boundaries of eating disorders and substance abuse.
‘Get drunk once or twice’
You may think that sports nutrition is an entirely contemporary concept that has only had a role to play in the athletes of the 20th and 21st centuries. And, for the most part, you’d be right.
However, going back to the origins of Olympia and a declared link between dietary decisions and sporting prowess are even evident then. The advice of Hippocrates in the ancient games was to ‘get drunk once or twice’ to cure sore muscles, turn to dairy or meat to find that extra boost when flagging, and to avoid wine, desserts and cold water while competing.
Eight drunken javelin throwers or balance beam gymnasts may not fit in with today’s health and safety regulations admittedly, but many of the concepts transcended over the centuries of sporting competition, and since the inception of the modern Olympics in 1886, the role of the diet has become ever-more prevalent.
The balance of minerals, vitamins, proteins and carbohydrates are no longer pondered upon by the baffled athlete themselves, but by the rather well paid nutritional scientists and doctors employed by coaching teams to ensure every ounce of fluid or food entering the body is accounted for and part of the long-term plan.
Boxers have often been singled out by the world’s media in the past in regards to their fluctuations in size and diets, due to the nature of a sport in which competitors can switch between weights categories and body shapes. This certainly isn’t the case in every sport though, further emphasising the necessity for athlete-specific regimes to be produced.
Even once the laborious and strict process of preparing for an Olympics or Paralympics is finished though, and the stadia begin to fill with expectant spectators, the monitored intake of nutrients still isn’t over. In the 1960s, researchers in Florida contributed to the drink now known as Gatorade, which is consumed right before, and during, intense competiton. This glucose and sucrose based drink is one of many that can be bought off the shelf to improve stamina and strength over long periods of sustained exertion, in what is now a multi-million dollar industry.
If you watch a tennis player in between changeovers, these drinks and specially made liquid foods will still be accompanied by the more traditional and natural banana, but finding the balance between the two as the sciences and technologies continue to advance is becoming more and more difficult.
A fine balance
Issues revolving performance enhancing drugs have raged on for decades now, heightened by incidents including the US team’s blatant testing of testosterone in 1956, or Ben Johnson’s too-good-to-be-true performance in Seoul in 1988.
Could we now be at a stage though, where the diet is questioned in equal measures to drug abuse? Afterall, in its most basic sense, athletes who are banned and labeled as drug cheats are done so due to them taking an unfair advantage through the substances going into their body prior to competition.
If nutritional science gets to the point where the foods and drinks consumed by athletes improves their stamina, strength or abilities, where do the ethical boundaries lie?
It is a fine balance within the Olympic and Paralympic community that will have to be monitored closely over the coming years, and is one of many.
Breaching everyday, social walks of life in elite sport carries risks, whether it relates to eating disorders within gymnastics and young teenage girls or the notion of planting the world’s largest McDonald’s in the middle of the Olympic Village for corporate reasons.
Food and drink plays a much bigger role in the development of sport and the athletes within these sports than it appears from the outside, but, with only three years and 11 months to get themselves in the best condition of their lives, there’s hardly time to waste pondering such implications. It just needs to be done.
The challenges to vaccine distribution affecting everyone
While it is comforting to know that vaccines against COVID-19 are showing remarkable efficacy, the world still faces intractable challenges with vaccine distribution. Specifically, the sheer number of vaccines required and the complexity of global supply chains are sure to present problems we have neither experienced nor even imagined.
Current projections estimate that we could need 12-15 billion doses of vaccine, but the largest vaccine manufacturers produce less than half this volume in a year. To understand the scale of the problem, imagine stacking one billion pennies – you would have a stack that is 950 miles high. Now, think of that times ten. This is a massive problem that one nation can’t solve alone.
Even if we have a vaccine – can we make enough? Based on current projections, Pfizer expects to produce up to 1.3 billion doses this year. Moderna is working to expand its capacity to one billion units this year. Serum Institute of India, the world’s largest vaccine producer, is likely to produce 60% of the 3 billion doses committed by AstraZeneca, Johnson & Johnson and Sanofi. This leaves us about 7 billion doses short.
Expanding vaccine production for most regions in the world is complicated and time-consuming. Unlike many traditional manufacturing operations that can expand relatively quickly and with limited regulation, pharmaceutical production must meet current good manufacturing practice (CGMP) guidelines. So, not only does it take time to transition from R&D to commercial manufacturing, but it could also take an additional six months to achieve CGMP certification.
The problem becomes even more complex when considering the co-products required. Glass vials and syringes are just two of the most essential co-products needed to produce a vaccine. Last year, before COVID-19, global demand for glass vials was 12 billion. Even if it is safe to dispense ten doses per vial, there is certain to be significant pressure on world supply of the materials needed to package and distribute a vaccine.
It is imperative drug manufacturers and their raw material suppliers have clear visibility of production plans and raw material availability if there is any hope of optimizing scarce resources and maximising production yield.
It is widely known by now that temperature is a critical factor for the COVID-19 vaccine. Even the regions with the most developed logistics infrastructures and resources needed to support a cold-chain network are sure to struggle with distribution.
For the United States alone, State and local health agencies have determined distribution costs will exceed $8.4 billion, including $3 billion for workforce recruitment and training; $1.2 billion for cold-chain, $1 billion vaccination sites and $0.5 billion IT upgrades.
The complexity of the problem increases further when considering countries such as India that do not have cold-chain logistics networks that meet vaccine requirements. Despite India’s network of 28,000 cold-chain units, none are capable of transporting vaccines below -25°Celsius. While India’s Serum Institute has licensed to manufacture AstraZeneca’s vaccine, which can reportedly be stored in standard refrigerated environments, even a regular vaccine cold chain poses major challenges.
Furthermore, security will undoubtedly become a significant concern that global authorities must address with a coordinated solution. According to the Pharmaceutical Security Institute, theft and counterfeiting of pharmaceutical products rose nearly 70% over the past five years. As with any valuable and scarce product, counterfeits will emerge. Suppliers and producers are actively working on innovative approaches to limit black-market interference. Corning, for example, is equipping vials with black-light verification to curb counterfeiting.
Clearly, this is a global problem that will require an unprecedented level of collaboration and coordination.
Disconnected information systems
While it is unreasonable to expect every country around the world will suddenly adopt a standard technology that would provide immediate, accurate and available information for everyone, it is not unreasonable to think that we can align on a standard taxonomy that can serve as a Rosetta Stone for collaboration.
A shared view of the situation (inventory, raw materials, delivery, defects) will provide every nation with the necessary information to make life-saving decisions, such as resource pooling, stock allocations and population coverage.
By allowing one central authority, such as the World Health Organization, to organize and align global leaders to a single collaboration standard, such as GS1, and a standard sharing protocol, such as DSCSA, then every supply chain participant will have the ability to predict, plan and execute in a way that maximises global health.
Political influence and social equality
As if we don’t have enough stress and churn in today’s geopolitical environment, we must now include the challenge of “vaccine nationalism.” While this might not appear to be a supply chain problem, per se, it is a critical challenge that will hinge on supply chain capabilities.
In response to the critical supply issues the world experienced with SARS-CoV-2, the World Health Organization, Gavi, the Vaccine Alliance and the Coalition for Epidemic Preparedness Innovations (CEPI) formed Covax: a coalition dedicated to equitable distribution of 2 billion doses of approved vaccines to its 172 member countries. Covax is currently facilitating a purchasing pool and has made commitments to buy massive quantities of approved vaccines when they become available.
However, several political powerhouse countries, such as the United States and Russia, are not participating. Instead, they are striking bilateral deals with drug manufacturers – essentially, competing with the rest of the world to secure a national supply. Allocating scarce resources is never easy, but when availability could mean the difference between life and death, it becomes almost impossible.
Global production, distribution and social equality present dependent yet conflicting realities that will demand global supply chains provide complete transparency and an immutable chain of custody imperative to vaccine distribution.
The technology is available today – we just need to use it. We have the ability to track every batch, pallet, box, vile and dose along the supply chain. We have the ability to know with absolute certainty that the vaccine is approved, where and when it was manufactured, how it was handled and whether it was compromised at any point in the supply chain. Modern blockchain technologies should be applied so that every nation, institution, regulator, doctor and patient can have confidence in knowing that they are making an impact in eradicating COVID-19.