The Hindu : Sport : All about therapeutic exemptions

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Thursday, Oct 19, 2006
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All about therapeutic exemptions

K.P. Mohan

Anti-doping rules do provide for a therapeutic use exemption Much will depend on the procedures the PCB will adopt

NEW DELHI: The news that Shoaib Akhtar had informed the International Cricket Council (ICC) of the list of medicines he was taking for an asthmatic condition need not mean much towards his defence when he faces a Pakistan Cricket Board (PCB) drugs tribunal to explain his side of the doping charge.

The Pakistan pace spearhead, who along with his bowling partner Mohammad Asif, turned up positive for steroid nandrolone in tests conducted by the PCB, has so far denied taking any banned substance knowingly.

Mere submission of information to the concerned federation regarding the drugs being consumed may mean very little in anti-doping parlance. A competitor is in any case expected to fill in information about the medicines he had been taking, in the doping form at the time of a dope control. A disclosure in a doping form, however, does not mean that an athlete has the right to consume banned substances.

Of no use

It will also be of no great use to a sportsperson to submit a set of prescriptions from a qualified doctor or doctors to support his argument that he needs to use medications for various ailments.

However, anti-doping rules do provide for a therapeutic use exemption (TUE) to those who need to use drugs that are otherwise banned by the World Anti Doping Agency (WADA).

A TUE has to be obtained in advance and it can be granted by the international federation concerned, a National anti-doping organization (in case of national-level athletes), WADA or the International Olympic Committee (in the case of Olympics).

Granting of TUE

As per the ICC rules, a TUE can only be granted if a committee appointed for the purpose comes to the conclusion that a player has a significant medical condition that requires treatment. The committee is required to take into consideration whether an unfair advantage could be drawn by the use of the prohibited drug or whether there was an alternative medication that could be used.

A TUE, if at all it is granted to any player during the ongoing Champions Trophy tournament, on an application that might have been filed more than three weeks ago, will be of no relevance in respect of a test that was conducted before its submission. For, the ICC anti-doping code (5.3.4) says: "A medical exemption/therapeutic use exemption cannot be granted retrospectively."

(WADA does provide for a TUE with retrospective effect in case there was a medical emergency or in case there was insufficient time for an applicant to submit, or a committee to consider, an application prior to a doping control).

The most important question, however, would be whether nandrolone is even remotely necessary for any medical condition that Akhtar could be having. For example, many asthma medications normally contain Beta-2 Agonists, in inhalers, and though they are otherwise banned, their use is permitted for inhaling alone provided an `abbreviated TUE' is obtained in advance.

Procedures tightened

Because of the large number of "asthma cases" that mysteriously crop up before every major games, the IOC and WADA have in recent years further tightened the procedures regarding granting of TUEs for medicines under the Beta-2 Agonists category.

One question that keeps cropping up relates to the "exceptional circumstances" rule by which an accused athlete can seek a reduction in the ineligibility period or even seek complete elimination of the suspension.

The ICC rules, surprisingly, are very simple for an accused cricketer to argue in his favour. A cricketer will have to prove that he bears no fault or negligence (or no significant fault or negligence) for the violation for a sanction to be eliminated or reduced. He of course will have to prove how the substance got into his body. If he is able to show that the particular substance had no performance enhancing effect, the period of ineligibility could be further reduced.

The relevant WADA rules, however, come with an explanation that an athlete cannot simply blame a trainer or a personal physician to argue that a medicine was consumed without him knowing it contained a prohibited substance.

Much will depend on the procedures the PCB will adopt and the rules under which it will conduct the hearings for the two cricketers.

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