IAAF could ban Kenya from 2016 Olympics
Kenya missed last week's deadline to prove it was adequately tackling doping issues and the IAAF president has confirmed he is prepared to implement the ultimate sanction on any nation guilty of attempting to cover up drug-taking.
"We know a disproportionate amount of reputational damage is caused by a relatively few countries and we have to be much more proactive," Coe said.
"Yes, if it means pulling them out of World Championships or Olympic Games then we will have to do that.
"I know the World Anti-Doping Agency has looked very closely at the Kenyan National Anti-Doping Agency. We, of course, monitor that through the IAAF, so that work is ongoing."
Coe has been under increasing pressure in recent weeks to fulfill his promise to clean up the sport and his task was made harder this week after the Athletics Kenya Chief Executive, Isaac Mwangi, was asked to step aside for 21 days pending an investigation into corruption allegations.
With Russia currently banned from world athletics following the discovery of widespread doping by WADA, Coe and the IAAF face the prospect of losing two of the sport's most powerful nations from Rio 2016.
Coe confirmed any decision on Russia's participation at the Games would depend on their compliance with WADA procedures, and that he would not be pressured by either governments or the Olympic movement into fast-tracking their return.
"We can make the changes but the journey is going to be ultimately when people, and particularly when clean athletes, feel they've got anti-doping systems that they can trust in," he said.
"Parents, who in large parts nudge their kids towards certain sports, they've got to feel that we're not a sport full of junkies."
The IAAF president has also been battling to keep sponsors on board, after both Nestle and Adidas recently announced their intention to end their partnerships with the governing body.
"They want to know what changes I am prepared to make," Coe added. "Am I serious about that? Yes, I am. Is it the only thing I'm focused on? Yes. Will we get those in place as quickly as we can? Yes, we will.
"But they have boards of shareholders, they have corporate governances themselves, so they are asking the right questions and a large part of my waking hours is flying around the world explaining to them why it is my intention to never return to this again."