Commenting on Fancy Bears hackers naming 25 players in the 2010 World Cup who used TUEs Dr John Dickinson, a world leading authority on respiratory problems in athletes, says the footballers have done nothing wrong.
‘I don’t think they have abused the system. Therapeutic Use Exemptions (TUEs) are, by definition, allowed – by the medical practitioner working with the athlete. They are used for the athlete’s health, when their medical condition means they need it in order to participate.
‘The issue comes if it is say a star player in the team who has a particular medical condition. There is a great deal of money in football, and there could be pressure to make sure there isn’t an issue when the player is on the pitch.
‘The supporting medical practitioners may be told they need to ensure it doesn’t become an issue when the athlete plays, what is the strongest medication that doesn’t give them side effects? This isn’t necessarily a problem – unless they need to use such strong medicine, you would question whether they should really be competing. And if one medical practitioner says “No”, then a club or team could simply find another who will.
‘Asthma is one of the more straightforward conditions because the athlete can be treated with almost all with standard inhalers but the sort you need for a TUE is strong medicine. If you need such strong medication, it’s quite clear from a health point of view that they are not healthy enough to compete. It is less clear whether we should be stopping athletes with other long term conditions, cancer for example.
‘At least with the Football World Cup, it won’t have made any difference to the results as it was 25 players across a number of teams and not an Olympic athlete competing alone.
‘What really needs to happen is more awareness rather than the rhetoric in sport that all drugs are bad. Some athletes have a medical requirement without everyone being tarnished.
‘The World Anti-Doping Agency (WADA) needs to improve communication about what is cheating and what is medical assistance. Then people would understand that a TUE means it is OK, they have permission. It wouldn’t be a shock because the general public would understand that it is allowed as long as it goes through correct, stringent processes.
‘There has been a call for athletes to publish what they are using and that would remove any interest in leaks of information but that would have to be balanced against privacy for an athlete’s condition.
Athletes have done nothing wrong as they have sought permission, it is the policies that need to be looked at. In football, new rules were introduced because players were found to be cheating by diving in the penalty box and video is now used to prevent it. WADA may need to look at how TUEs are used in football and introduce new criteria and rules if necessary.
‘This issue stemmed from the leaks about the Olympics and it is interesting how issues in the Games transfer to professional sport. I wouldn’t be surprised if the next leaks were in tennis or rugby. WADA needs to ensure that athletes need strong medication for a true medical reason and not allow the system to be open for athletes to bend the rules and use these medications to aid their performance.’
Dr John Dickinson, has more than 10 years experience of investigating issues such as asthma and dysfunctional breathing in athletes. He is a member of the Endurance Research Group and the Sports Therapy, Physical Activity and Health Research Group in the School of Sport & Exercise Sciences. He has received funding from the World Anti-Doping Agency (WADA) to investigate the properties of inhaled asthma medication.