Fair and clean competition in sports, without the use of substances to improve the players’ performances has always been extremely important. The first federation that prohibited the use of specific stimulants in 1928 was the International Amateur Athletics Federation. Later, in 1967, a ‘Prohibited List’ of stimulants and narcotics was created by the International Olympic Committee (IOC). Finally, in 2004, the responsibility of publishing the list was transferred to the World Anti-Doping Agency (WADA).
With time, the list kept growing and started including common therapeutic agents such as glucocorticoids and insulin as well. This led to the need for medical exemptions to make sure that the rules remained fair for athletes with manageable medical conditions. So the concept of Therapeutic Use Exemption was introduced.
Therapeutic Use Exemption (TUE) is granted to athletes with clinical conditions, under carefully defined criteria, allowing them to use substances or methods in the prohibited list. It is a regulated process that is well-defined in the World Anti-Doping Code and the International Standard for Therapeutic Use Exemptions (ISTUE).
A TUE is granted only to those athletes who meet the critical ISTUE criteria, as evaluated by an independent panel of physicians, called the TUE Committee.
Eventually the media started suspecting that the numerous athletes in the elite sports, who had TUEs, were cheating and taking advantage of the rule. A report from WADA showed that during the 2016 Summer and 2018 Winter Olympic Games, there were 11,303 and 2,922 athletes respectively. Among them, approximately 1.2% athletes in each game had valid TUEs. So even though the number of athletes with TUEs was low, it was possible for every athlete with a TUE to win a medal.
Hence, a study was conducted to describe the TUEs presence in the five games between 2010 and 2018. The aim was to find out whether the athletes with TUEs had better chances of winning a medal than those without TUEs.
After a thorough research of the events in the five games, it was found that less than 0.1% of athletes participated in individual events with a TUE; and looking at all the resources available to them, there wasn’t much evidence to suggest that an athlete with a TUE has better chances of winning a medal than one without a TUE.
So it’s safe to say that the process of granting a TUE is a well-regulated and controlled one and having a TUE doesn’t give any unfair advantage to the athlete. The events are still as fair as they can be.
TUE Process Performed by the ADMAC (Australian Sports Drug Medical Advisory Committee)
The ASDMAC is given 21 days’ time to evaluate a TUE application with all the medical evidence provided by the athlete. An incomplete application is not considered and is returned to the athlete.
If the committee approves the application, it issues a TUE certificate to the athlete and copies are sent to the athlete’s doctor and his/her sporting administration body.
The validity of a TUE depends on the substance that the athlete needs to use. It can last from weeks to years. Once expired, the TUE can be renewed if the athlete needs to continue the medication.