SL_Module_6

Module 6:
Doping and Anti-Doping Code

WHAT IS DOPING?

WHAT WILL WE LEARN 'Doping' refers to an athlete's use of prohibited
drugs or methods to improve training and
•What is Doping? sporting results. Doping, other than steroids
•World Anti-Doping Code includes an athlete's use of steroids and
•Purpose and scope of World Anti-Doping other forbidden drugs , use of forbidden
methods(such as blood transfusions or gene
Agency doping), and even the refusal to take a drug
•Responsibilities of Sportsperson test or an attempt to tamper with doping
•Identify the various violations under the controls. Doping therefore usually means
athletes taking illegal substances to improve
World Anti-Doping Code their performances.
•Therapeutic use: exemptions to anti-doping

regulation
•The sanctions for anti-doping rule violations

There are five classes of banned drugs, the
most common of which are stimulants and hormones. There are health risks involved in taking
them and they are banned by sports' governing bodies. Substances and doping methods are banned
when they meet at least two of the three following criteria: they enhance performance, pose a threat
to athlete health, or violate the spirit of sport.1 The use of stimulants and strength-building
substances in sport is held to date back as far as Ancient Greece, but it was during the 1920s that
restrictions about drug use in sport were first thought necessary. In 1928 the International
Association of Athletics Federations (IAAF) - athletics' world governing body - became the first
international sports federation to ban doping.2

1 http://www.ukad.org.uk/assets/uploads/Files/2012/06/Substances_and_methods_explained_Fact_sheet.pdf
2 Doping in sport: What is it and how is it being tackled?, August 20, 2015. [Available at

http://www.bbc.com/sport/athletics/33997246, last accessed on January 13, 2013, 18:10]

HISTORY

When humans compete against one another, either in war, in business, or in sport, the competitors,
by definition, seek to achieve an advantage over their opponent. Frequently they use drugs and
other substances to gain the upper hand. Furthermore, there have always been individuals who in
the pursuit of victory have transcended social norms.

The use of drugs to enhance performance in sports has certainly occurred since the time of the
original Olympic Games [from 776 to 393 BC]. The origin of the word 'doping' is attributed to the
Dutch word 'doop,' which is a viscous opium juice, the drug of choice of the ancient Greeks.3 By
1933 the word doping had become part of the English language4. While Rieser and others
continued to speak out against doping, it was not until 1967 that the International Olympic
Committee (IOC) voted to adopt a drug-testing policy banning the use of specific drugs5.

Doping in modern sport has been reported since the middle of the 19th Century, including the
death of an English cyclist in 1896 after he used ephedrine during the Paris-Bordeaux cycle race.
A dramatic increase in doping in sport was registered from the 1960s onwards and the first doping
controls were introduced at the 1976 Olympic Games in Montreal. Two weightlifters had to return
their gold medals at those Olympics after they were found to have doped. In 1974, reliable testing
methods were discovered for testosterone and anabolic steroids, which were added to the
International Olympic Committee’s list of Prohibited Substances in 1976. This led to a number of
doping-related disqualifications in the late 1970s. However so strong suspicions related to state-
sponsored doping practices in some countries, such as the German Democratic Republic persisted.

At the 1983 Pan-American Games in Caracas, Venezuela, many athletes withdrew after they had
learned of a new and more rigorous testing regime had been introduced. However, it was in 1988

3 Larry D. Bowers, PhD "Athletic Drug Testing," Clinics in Sports Medicine, Apr. 1, 1998

4 Prokop, 1970
5 Todd & Todd, 2001

Seoul Olympic Games that really brought doping in sport to the world’s attention when Canadian
sprinter, Ben Johnson was stripped of his 100m gold medal after testing positive for anabolic
steroid use. In the 1990s, there was a shift from the use of stimulants and anabolic steroids to blood
doping with EPO and human growth hormone. This period of time also saw the introduction of
Athlete Whereabouts Programmes to track athletes’ movements to enable out-of-competition
testing.6

In 1966, the world governing bodies for cycling and football were the first to introduce doping
tests in their respective world championships, with the first Olympic testing coming in 1968, at
the Winter Games in Grenoble and Summer Games in Mexico. By the 1970s, most international
federations had introduced drug-testing. A major drug scandal at the 1998 Tour de France
underlined the need for an independent international agency to set standards in anti-doping work.
The World Anti-Doping Agency (Wada) was thereafter established in the following year.

In January 2013, the retired American cyclist Lance Armstrong admitted to doping in an interview
with Oprah Winfrey, and was stripped of his seven Tour de France wins and banned from sport
for life.

DRUGS MOST COMMONLY USED IN DOPING

1. The most commonly used substances in sport doping include androgenic agents such
as anabolic steroids. They allow the athletes to train harder, recover more quickly and
build more muscle, but they can lead to kidney damage and increased aggression.
Anabolic steroids are usually taken either in tablet form or injected into muscles. Some
are applied to the skin in creams or gels.

2. Then there are stimulants, which make athletes more alert and can overcome the effects
of fatigue by increasing heart-rate and blood flow. But they are addictive and, in
extreme cases, can lead to heart failure.

6 http://drugfreesport.org.nz/what-we-do/about-doping-in-sport/history

3. Diuretics and masking agents are used to remove fluid from the body, which can hide
other drug use or, in sports such as boxing and horse racing, help competitors "make
the weight".

4. Narcotic analgesics and cannabinoids are used to mask the pain caused by injury or
fatigue - but in practice can make injuries worse. They are also addictive. Products
such as morphine and oxycodone are banned but the opiate-derived painkiller codeine
is allowed.

5. Peptide hormones are substances such as EPO (erythropoietin) – which increases
bulk, strength and red blood cell count and gives athletes more energy - and HGH
(human growth hormone), which builds muscle.

6. Blood doping which is less common is where blood is removed from the body and
injected back in later to boost oxygen levels. This practice, which can lead to kidney
and heart failure, is banned.

7. Glucocorticoids mask serious injury because they are anti-inflammatories and affect
the metabolism of carbohydrates, fat and proteins, and regulate glycogen and blood
pressure levels.

8. Beta blockers, meanwhile, which may be prescribed for heart attack prevention and
high blood pressure, are banned in sports such as archery and shooting because they
keep the heart-rate low and reduce trembling in the hands.

WORLD ANTI-DOPING CODE

The World Anti-Doping Code (Code) is the core document that harmonizes anti-doping policies,
rules and regulations within sport organizations and among public authorities around the world. It
works in conjunction with five International Standards which aim to foster consistency among
anti-doping organizations in various areas: testing; laboratories; Therapeutic Use Exemptions
(TUEs); the List of Prohibited Substances and Methods; and the protection of privacy and personal
information.7

7 https://www.wada-ama.org/en/what-we-do/the-code

The five international standards are:

1. The Prohibited List
The prohibited list outlines the substances and methods prohibited in sport. It is known
as the corner-stone of the WADA code, and also the key of harmonization. Since, 2004,
WADA annually publishes the list. The substances and methods which are not
mentioned in the list are kept under supervision. The Monitoring systems have been
established to supervise the usage of those unlisted substances.8

2. International Standard for Testing & Investigations
Testing is an extremely crucial piece of any anti-doping program. The purpose of the
International Standard for Testing & Investigations (ISTI) is to plan for effective testing
and to maintain the integrity and identity of samples, from notifying the athlete to
transporting samples for analysis.

3. International Standard for Therapeutic Use Exemptions
The purpose of the International Standard for Therapeutic Use Exemptions (ISTUE) is
to harmonize the process of granting TUEs across sports and countries. The WADA
TUE process ensures athletes can get access to important medication when appropriate
while ensuring clean athletes a level playing field.

4. International Standard for Laboratories
The purpose of the International Standard for Laboratories (ISL) is to ensure production
of valid test results and evidentiary data and to achieve uniform and harmonized results
and reporting from all accredited laboratories. Anti-doping and other sport
organizations which are signatories to the Code agree to have all samples analyzed at
WADA accredited labs.

5. International for Protection of Privacy and Personal Information

8 Prohibited List, World Anti-Doping Agency website. [Available at https://www.wada-ama.org/en/what-we-
do/prohibited-list, last accessed at 13th January, 05:34 pm].

The purpose of the International Standard for the Protection of Privacy and Personal
Information (ISPPPI) is to ensure that all relevant parties involved in anti-doping in
sport adhere to a set of minimum privacy protections when collecting and using athlete
personal information, such as information relating to whereabouts, doping controls, and
Therapeutic Use Exemptions.

This unified approach addresses problems that previously arose from disjointed and uncoordinated
anti-doping efforts, including, among others: a scarcity and splintering of resources required to
conduct research and testing; a lack of knowledge about specific substances and procedures being
used and to what degree; and an inconsistent approach to sanctions for those athletes found guilty
of doping.9

In 2004, the World Anti-Doping Code was implemented by sports organizations prior to
the Olympic Games in Athens, Greece. In November 2007, more than 600 sports organizations
(international sports federations, national anti-doping organizations, the International Olympic
Committee, the International Paralympic Committee, and a number of professional leagues in
various countries of the world) unanimously adopted a revised Code at the Third World
Conference on Doping in Sport, to take effect on January 1, 2009.10

The adoption of the Code has led to several significant advances in the global fight against doping
in sport and sporting industry, including the formalization of certain rules and the clarification of
stakeholder responsibilities. This new approach to anti-doping has brought in consistency to a
previously disjointed and classified system. The Code has also been significantly instrumental in
introducing the core concept of “non-analytical” rule violations. Non-analytical rule violations
means there is no positive doping evidence at hand. However it allows anti-doping organizations
to apply sanctions in such cases where there is no positive doping sample, but where there may
still be evidence that a doping violation has occurred (e.g. through a combination of three missed

9 https://www.wada-ama.org/en/what-we-do/the-code
10 Zorea, Aharon (2014). Steroids (Health and Medical Issues Today). Westport, CT: Greenwood Press. pp. 77–83.

tests / Whereabouts failures; longitudinal testing; evidence brought forward through an
investigation).

Till date, more than 660 sport organizations have accepted the World Anti-Doping Code. These
organizations include the: -

• International Olympic Committee (IOC),
• The International Paralympic Committee (IPC)
• Olympic Sport International Federations (IFs)
• All IOC-recognized IFs
• National Olympic and Paralympic Committees
• National Anti-Doping Organizations

Sports are required to undertake three steps in order to be fully compliant with the Code:

1. Acceptance

2. Implementation

3. Enforcement

Code acceptance means that a sport organization agrees to the principles of the Code and agrees
to implement and comply with the Code.

Once a sport organization accepts the Code, it must then implement it. The implementation of the
Code is the process that an anti-doping organization goes through to amend its rules and policies
so that all mandatory articles and principles of the Code are included.

Finally, enforcement refers to the sport organization actually enforcing its amended rules and
policies in accordance with the Code.11

Sport organizations within the following categories have accepted the Code:

• Olympic Movement

11 https://www.wada-ama.org/en/what-we-do/the-code

• Government-Funded Organizations
• Outside the Olympic Movement

For a full list of signatories you can follow the given link: https://www.wada-
ama.org/en/code-signatories

The code is not a static instrument. In order to meet the constantly changing forms of doping the
regulations have also improved to tackle the upcoming issues. The international anti-doping
community, including WADA and all of the Code-Signatories, completed a full review and
revision of the 2009 World Anti-Doping Code; and as a result, on January 1, 2015, a new World
Anti-Doping Code took effect. The 2015 Code has been designed to even better protect the rights
of clean athletes and the integrity of competition with a focus on targeting current issues in the
fight against doping, while simultaneously being tougher for those who intentionally cheat and
easier for those who follow the rules and compete clean.

The most significant changes brought about by the 2015 Code include:

1. Whereabouts: Under the 2015 World Anti-Doping Code, any combination of three
whereabouts failures, which include filing failures or missed tests within a rolling 12-
month period may result in an anti-doping rule violation and lead to a loss of funding,
medals, prizes and other money, as well as losing the chance to compete.
This is a change from the previous Code in which an anti-doping rule violation resulted
from three failures in an 18-month period.

2. 60 Minute Window: Athletes in the ITP(International Testing Pool) are required to
provide a 60-minute time slot for a location they will be at and available for testing
each day of the quarter. Starting on January 1, 2015, the 2015 Code will allow athletes
to select that 60-minute time slot to be as early as 5 a.m., giving athletes more
flexibility.

3. Prohibited Association: The 2015 World Anti-Doping Code recognizes the fact that
athletes who want to cheat don’t typically do it alone. To help protect athletes from
people who would use their position of power or influence to prey on them, the 2015
Code will prohibit athletes from associating with coaches, trainers, physicians, or other
athlete support personnel who are sanctioned and/or criminally convicted of doping.

Some examples of assistance include obtaining training, nutrition, or medical advice,
and/or allowing the individual to serve as an agent or representative.
4. Sanction Changes: Starting January 1, 2015, athletes may receive a 4-year ban from
competition for a first offense for the presence, use, attempted use, or possession of a
prohibited substance or prohibited method. In addition, any athlete who refuses to
participate in, evades, or tampers with the sample collection process, may also be
subject to a sanction of up to 4 years. According to research done by the World Anti-
Doping Agency, there was a strong consensus among stakeholders, and in particular,
athletes, that intentional cheaters should be ineligible for a period of four years. There
was also stakeholder consensus that more flexibility in sanctioning should be permitted
in certain circumstances where the athlete can demonstrate that he or she was not
cheating.
5. Return from Retirement: Athletes will now have to be in RTP six months prior to
making a full return from retirement. Waivers to this rule will be granted from WADA
now and not the USOC. Retired athletes who wish to return to competition must be
included in a registered testing pool and available for testing for a set period of time
before they can participate in competition. This time period is designed to ensure that
returning athletes have been subject to the same anti-doping standards as current
athletes.

6. Other Changes:
i. The Storage of samples for WADA-accredited laboratories has
increased from 8 years to 10 years.
ii. The Statute of Limitations for anti-doping rule violations has increased
from 8 years to 10 years.
iii. Therapeutic use exemptions must be mutually recognized by
international federations and national anti-doping organizations around
the world.

PURPOSE AND SCOPE OF WORLD ANTI DOPING AGENCY

The World Anti-Doping Agency was founded with the aim of bringing consistency to anti-doping
policies and regulations within sport organizations and governments’ right across the world. The
World Anti-Doping Agency (WADA) was established in 1999 as an international independent
agency composed and funded equally by the sport movement and governments of the world. Its
key activities include scientific research, education, development of anti-doping capacities, and
monitoring of the World Anti-Doping Code (Code) – the document harmonizing anti-doping
policies in all sports and all countries.12

SCOPE
Code Acceptance, Implementation & Compliance As the international, independent organization
responsible for the Code, WADA has the duty to monitor the three aspects of stakeholder Code
activities—from acceptance to implementation to compliance. WADA therefore facilitates and
monitors government and sport anti-doping efforts, taking necessary measures to ensure the
integrity of the Code. This includes working with governments in their ratification of the UNESCO
International Convention against Doping in Sport—the practical tool enabling governments to
align domestic policy with the Code, thus harmonizing the rules governing anti-doping in sport.
In working with the sport movement, WADA aims to ensure that sports rules are consistent with
the Code and that they are enforced as such. WADA helps stakeholders fulfill their responsibilities
under the Code through a variety of means. WADA has the duty to review sanctions and to seek
appeal to the Court of Arbitration for Sport (CAS) when decisions in doping cases are not Code-
compliant. Furthermore, WADA ensures that the Code evolves regularly by engaging in extensive
consultation and thorough review of the Code and its associated International Standards, on a
periodic basis.

12 https://www.wada-ama.org/en/who-we-are

Anti-Doping Development
To help ensure that all athletes benefit from the same antidoping protocols and protections, no
matter the nationality, the sport, or the country where tested, WADA facilitates the coordination
of Regional Anti-Doping Organizations (RADOs). WADA brings together countries in regions
where there are no, or limited, anti-doping activities, so that they can pool human and financial
resources in developing and managing their own anti-doping organization.

Anti-Doping Coordination (ADAMS) Pursuant to its coordination responsibilities, WADA
developed, maintains and regularly improves ADAMS (Anti-Doping Development Management
System), the Web-based database management system that assists stakeholders in complying with
the Code. Within one secure system, stakeholders can coordinate anti-doping activities, from
athletes providing whereabouts information, to anti-doping organizations ordering tests and
managing results, to laboratories reporting results.

Cooperation with Law Enforcement WADA is constantly looking at innovative strategies to fight
against doping in sport. Considering that law enforcement and government agencies possess
investigative powers to attack source and supply of illegal substances, which in many cases
uncover evidence of anti-doping rule violations, WADA has developed protocols to ensure
evidence gathering and information sharing between its two stakeholder groups (governments and
sport). WADA cooperates closely with Interpol, the world’s largest police organization, in this
area. In addition, WADA works with UNESCO and individual governments to persuade
governments to have laws in place that allow combating manufacturing, supply and possession of
doping substances on their territories.

Science & Medicine Pursuant to the Code, WADA is responsible for annually preparing and
publishing the List of Prohibited Substances and Methods in consultation with panels of experts
in the field as well as the Agency’s many stakeholders. The Agency also fosters scientific research

dedicated to developing new and improved detection methods for performance-enhancing
substances and methods. WADA is responsible for accrediting the world’s network of anti-doping
laboratories. WADA monitors the Therapeutic Use Exemption (TUE) process implemented by
anti-doping organizations around the world to ensure compliance with the International Standard
for TUE. In addition, the Agency explores new models for enhanced detection such as the Athlete
Passport Program (whereby an athlete’s biological parameters are monitored, which can reveal
doping).

Education WADA leads and coordinates effective prevention programs and assists stakeholders in
building knowledge and capacity to carry out their own effective education activities. WADA’s
goal is to provide a mechanism to empower athletes and youth to make informed decisions to
protect the integrity of sport. The Agency’s Education Seminars and Workshops, hosted in key
regions of the world, in partnership with RADOs, help raise understanding about anti-doping
efforts among stakeholders and offer guidance and practical tools to initiate or enhance doping
prevention programs worldwide. WADA’s Social Science Research Program fosters
understanding of attitudinal and behavioural aspects of doping to enhance doping prevention
strategies. The Agency’s Youth Program offers guidance and material for integrating anti-doping
messages into the school curriculum. WADA’s Play True Generation Program reaches athletes
during multi-national, multi-sport youth events.

Athlete Outreach WADA’s Athlete Committee, composed of current and former elite international
athletes representing the voice of the clean athlete, provides feedback on WADA programs and
speaks out on issues that are important to clean athletes. WADA’s Athlete Outreach Program
educates athletes and their support personnel at major international and multisport events through
direct, one-on-one, interaction with anti-doping experts, answering their questions about the
dangers and consequences of doping and providing information resources. The WADA Athlete
Outreach Model empowers stakeholders to develop and implement their own sport-specific or
national awareness programs to educate their athletes about the fight against doping in sport.

RESPONSIBILITY OF SPORTSPERSONS

When was the last time that an athlete in any sport who tested positive said: "I'm sorry. I
deliberately cheated. I have been cheating for (weeks, months or years). I did so because I wanted
to win and I was willing to do anything to achieve that objective." Or: "I'm sorry. I made a mistake.
I did not intend to deliberately cheat but that is what happened. I unwittingly used a product for
(weeks, months or years) that had a banned substance in it. I apologize to all of the athletes against
whom I've competed and denied them cherished wins. I should have been more careful. It's my
fault." More often than not, athletes who test positive go into denial. It's understandable but not
excusable. There must be zero tolerance for those who test positive. Responsibility starts and ends
with each athlete.

Introduced in 2004, the World Anti-Doping Code (the Code) lists in detail every prohibited
substance and method, the regulations for testing, and rules to protect athletes’ privacy. The Code
is clear that Athletes are bound to comply with the Code through membership of the National
Governing Body in their sport. Every athlete must take ultimate responsibility for every substance
that enters their body. The following are the responsibilities of athletes in relation to doping control
under the 2015 Code:

• Be aware of and comply with their sports anti-doping policy (including the provision of
accurate whereabouts information)

• Be available for and comply with sample collection procedures

• Remain in sight of the official at all times until the Sample Collection Procedures are
complete (once notified for sample collection)

• Report to the Doping Control Station as soon as practical or within 60 minutes

• Whichever is sooner after being notified that they are required to provide a sample

• They control the sample until it is sealed in the sample collection equipment

• The sealed sample collection kit is secure and identified

• All appropriate documentation is accurate, complete and signed

• Be aware of which substance are prohibited

VIOLATIONS UNDER WORLD ANTI DOPING CODE

In the 2015 World Anti-Doping Code there are 10 Anti-Doping Rule Violations (ADRV). They
consist of the following:

• The presence of a prohibited substance or its metabolites or markers in an athlete’s sample:
It is each Athlete’s personal duty to ensure that no Prohibited Substance enters his or her
body. Athletes are responsible for any Prohibited Substance or its Metabolites or Markers
found to be present in their Samples. Accordingly, it is not necessary that intent, Fault,
negligence or knowing use on the Athlete’s part be demonstrated in order to establish an
anti-doping rule violation. (Article 2.1)

• Use or attempted use by an athlete of a prohibited substance or a prohibited method: It is
each Athlete’s personal duty to ensure that no Prohibited Substance enters his or her body
and that no Prohibited Method is used. Accordingly, it is not necessary that intent, Fault,
negligence or knowing use on the Athlete’s part be demonstrated in order to establish an
antidoping rule violation for Use of a Prohibited Substance or a Prohibited Method. The
success or failure of the Use or Attempted Use of a Prohibited Substance or Prohibited
Method is not material. It is sufficient that the Prohibited Substance or Prohibited Method
was Used or Attempted to be Used for an anti-doping rule violation to be committed.
(Article 2.2)

• Evading, refusing, or failing to submit to sample collection: Evading Sample collection, or
without compelling justification, refusing or failing to submit to Sample collection after

notification as authorized in these Anti-Doping Rules or other applicable anti-doping rules.
( Article 2.3)

• Whereabouts failures: any combination of three missed tests and/or filing failures within a
12-month period by an athlete in a registered testing pool: Any combination of three missed
tests and/or filing failures, as defined in the International Standard for Testing and
Investigations, within a twelve-month period by an Athlete in a Registered Testing Pool.

• Tampering or attempted tampering with any part of doping control: Conduct which
subverts the Doping Control process but which would not otherwise be included in the
definition of Prohibited Methods. Tampering shall include, without limitation,
intentionally interfering or attempting to interfere with a Doping Control official, providing
fraudulent information to an Anti-Doping Organization or intimidating or attempting to
intimidate a potential witness. (Article 2.5)

• Possession of a prohibited substance or prohibited method: Possession by an Athlete In-
Competition of any Prohibited Substance or any Prohibited Method, or Possession by an
Athlete Out-of-Competition of any Prohibited Substance or any Prohibited Method which
is prohibited Out-of-Competition unless the Athlete establishes that the Possession is
consistent with a Therapeutic Use Exemption (“TUE”) granted in accordance with Article
4.4 or other acceptable justification and possession by an Athlete Support Person In-
Competition of any Prohibited Substance or any Prohibited Method, or Possession by an
Athlete Support Person Out-of-Competition of any Prohibited Substance or any Prohibited
Method which is prohibited Out-of-Competition in connection with an Athlete,
Competition or training, unless the Athlete Support Person establishes that the Possession
is consistent with a TUE granted to an Athlete in accordance with Article 4.4 or other
acceptable justification. (Article 2.6)

• Trafficking or attempted trafficking in any prohibited substance or prohibited method (Rule
2.7)

• Administration or attempted administration to any athlete in-competition of any prohibited
method or prohibited substance, or administration or attempted administration to any
athlete out-of-competition of any prohibited method or any prohibited substance that is
prohibited out-of-competition (Rule 2.8)

• Complicity: assisting, encouraging, aiding, abetting, conspiring, covering up or any other
type of intentional complicity involving an ADRV or any attempted ADRV: Assisting,
encouraging, aiding, abetting, conspiring, covering up or any other type of intentional
complicity involving an anti-doping rule violation, Attempted anti-doping rule violation or
violation of Article 10.12.1 by another Person. ( Rule 2.9)

• Prohibited Association: associating with a person such as a coach, doctor or physio who
has been found guilty of a criminal or disciplinary offence equivalent to a doping violation
( Rule 2.10)

THEREPEUTIC USE EXEMPTION

The Therapeutic Use Exemption (TUE) process is a means by which an athlete can obtain approval
to use a prescribed prohibited substance or method for the treatment of a legitimate medical
condition.13 Athletes may have illnesses or conditions that require them to take particular
medications. If the medication an athlete is required to take to treat an illness or condition happens

13 http://ukad.org.uk/medications-and-substances/about-TUE/

to fall under the Prohibited List, a Therapeutic Use Exemption (TUE) may give that athlete the
authorization to take the needed medicine.

The purpose of the International Standard for Therapeutic Use Exemptions (ISTUE) is to ensure
that the process of granting TUEs is harmonized across sports and countries.

Article 4.1-4.3 of the International Standard for Therapeutic Use Exemptions governs the criteria
for granting such an exemption. The system is so designed as to ensure that those with a genuine
medical condition for which there is no effective alternative treatment are not unfairly penalized,
while simultaneously at the same time trying to prevent them gaining an undue advantage over
others. These exemptions are only valid for as long as the specific condition, which allows them
to use such drugs persists, although in some cases that means an athlete's entire career. Athletes
must apply to their national anti-doping agency or international federation for a TUE, but they can
also be issued retrospectively subsequently. It has been reported that Lance Armstrong, for
example, once escaped a ban by obtaining a TUE for cortisone after testing positive for the drug
in 1999.

As per Article 4.1, an Athlete may be granted a TUE if (and only if) he/she can show, by a balance
of probability, that each of the following conditions is met:

a. The Prohibited Substance or Prohibited Method in question is needed to treat an acute
or chronic medical condition, such that the Athlete would experience a significant
impairment to health if the Prohibited Substance or Prohibited Method were to be
withheld.

b. The Therapeutic Use of the Prohibited Substance or Prohibited Method is highly
unlikely to produce any additional enhancement of performance beyond what might
be anticipated by a return to the Athlete’s normal state of health following the
treatment of the acute or chronic medical condition.

c. There is no reasonable Therapeutic alternative to the Use of the Prohibited Substance
or Prohibited Method.

d. The necessity for the Use of the Prohibited Substance or Prohibited Method is not a
consequence, wholly or in part, of the prior Use (without a TUE) of a substance or
method which was prohibited at the time of such Use.

Article 4.2 provides that, unless one of the exceptions set out in Article 4.3 applies, an Athlete who
needs to Use a Prohibited Substance or Prohibited Method for Therapeutic reasons must obtain a
TUE prior to Using or Possessing the substance or method in question.

Article 4.3 on the other hand provides that, retroactive approval to an athlete for his/her
Therapeutic Use of a Prohibited Substance or Prohibited Method (i.e., a retroactive TUE) can be
only granted if:

a. Emergency treatment or treatment of an acute medical condition was necessary; or
b. Due to other exceptional circumstances, there was insufficient time or opportunity

for the Athlete to submit, or for the TUEC to consider, an application for the TUE
prior to Sample collection; or
c. The applicable rules required the Athlete (see comment to Article 5.1) or permitted
the Athlete (see Code Article 4.4.5) to apply for a retroactive TUE; or
d. It is agreed, by WADA and by the Anti-Doping Organization to whom the
application for a retroactive TUE is or would be made, that fairness requires the
grant of a retroactive TUE.

TUE, CORRUPTION, AND MISUSE

However, over the years the wider question of whether the widespread use of TUE [Therapeutic
usage exemption] is appropriate or not is one which is being increasingly debated within
international as well as regional anti-doping and sports science fraternities. Some strongly believe
that while what started out as a genuine and legitimate practice has now been corrupted and used
as a mere excuse to avoid doping charges. The debate is also about whether the TUEs merely level
the playing field or bestow an unfair advantage upon its exemptee. The questions raised against
TUE is also about whether the process of granting a TUE is rigorous enough and whether there is
any check or balance mechanism to inquire into the corruption that may be persisting within the
system of granting such approvals. Another question that arises is whether there is process of
timely review of such TUE is thoroughly being followed as many TUEs bestow advantages on an
athlete’s performance which results in the kind of unfair advantage which is quite beyond repair.
Perhaps a new fairer system needs to be incorporated to fill out the loop holes of the current system
so as to level the playing field.