This year Olympic Games could feature an athletics program without two of the sport’s most powerful nations - Russia and Kenya - while a third, Ethiopia, is under immense pressure to show it has adequate anti-doping measures.
Ethiopia is the latest to have its credibility questioned after it was announced last month that six athletes, some of them elite performers, are under investigation for doping.
In addition, former middle-distance world champion Abeba Aregawi, an Ethiopian-turned-Swede, has tested positive.
Russia is currently banned from all athletics following discovery of a state-sponsored doping regime and revelations of corruption.
Kenya, having missed a World Anti-Doping Agency (WADA) deadline last month, has now been given until May 12 to show it has adequate systems in place after a series of high-profile positive tests by athletes and the suspension of several leading athletics officials.
That is the backdrop to a meeting of the International Association of Athletics Federations (IAAF) Council on Thursday and Friday where President Sebastian Coe will be fighting to restore the credibility of the sport he graced on the track.
Coe won his two 1,500m golds at the 1980 and 1984 Games, both of which were hit by political boycotts, and results from Rio in August could end up carrying a similar asterisk.
Russia has finished second to the United States in the athletics medal table in the last three Olympics while it was top of the tree in the last three editions of the world championships.
The two east African countries have had a stranglehold on the longer distances for both genders.
In the last five world championships Kenya has averaged above five golds, and 13 medals, with Ethiopia not far behind. It is a similar story at the last five Olympics where Kenya have won 12 gold and 47 track and field medals and Ethiopia 15 gold and 32 in total.
That sustained success, however, is now viewed through the prism of widespread drug-taking and poor controls.
Question of sport
The IAAF will discuss progress Russia has made following visits from an IAAF task force and WADA officials but the country appears to be losing its battle to claim re-admission in time for the Rio de Janeiro Games in August.
Kenya, whose federation is in disarray after recent suspensions, has a matter of weeks to persuade WADA they are “code-compliant”, or face joining Russia on the sidelines.
Ethiopia has so far escaped censure from WADA but the organization has instructed the country to improve its program and develop its own anti-doping organization after the its athletics doctor Ayalew Tilhaun called their growing drugs problem "a terrifying development."
"Ethiopia hasn’t been declared non-compliant but it faces serious questions,” former WADA head Dick Pound told Reuters.
The head of Ethiopian athletics, Bililign Mekoya, told Reuters: We are not a country known for committing such offenses but this has become a global phenomenon. We ... are working to strengthen our capacity and have recently formed our own anti-doping agency.”
Those promises sound hopeful but one Ethiopian athletics official told Reuters that the country was a long way from establishing a credible service.
Speaking on condition of anonymity, the official said the Ethiopia's capacity to tackle doping "does not amount to having more than a few first aid kits".