Article Text
Abstract
Lecture 2
The main objectives of the fight against doping in sports are the protection of health and fair competition in the defence of clean athletes.
The fight against doping is getting more and more complex in order to cope with the increasing sophistication of the doping practices used by the cheaters.
In 1994 the IOC implemented for the first time the out of competition anti-doping controls. The idea was to prevent the use of prohibits substances and methods by athletes during the periods between competitions and the strategy of waiting for the time needed to excrete the substances or its metabolites from the body to compete. The idea was good enough but the cheaters could work around it by evading the tests during those excretion periods. In order to solve this problem, the World Anti-Doping Agency (WADA) decided to create for the best athletes worldwide a system to facilitate their localisation – the Whereabouts Information System.1 This new system forced the athletes to send, for each trimester, data concerning their localisation and a 60 min time slot associated to a precise location where they had to be found in order to be tested.
The athletes have an essential right – the right to the ideal medical treatment. Sometimes they need to use prohibited substances and methods in order to achieve it. WADA established procedures and specific criteria to fulfil this essential right, creating the International Standard for Therapeutic Use Exemptions (TUE).2 The anti-doping organisations all over the world must have TUE Committees to evaluate those exemptions. If an adverse analytical finding is determined, these TUE must be shared between the relevant organisations.
The cheaters use erythropoiesis-stimulating agents, blood transfusions and other prohibited substances and methods for the enhancement of oxygen transfer, essential for the performance in the majority of sports. Some of these substances and methods can increase the performance in up to 30%. Some of these substances and methods have a very narrow window of detection, sometimes less than 24 h and some are even impossible to detect. WADA decided to implement the Athlete's Biological Passport,3 trying to solve this problem. The plan was to establish biomarkers profiles for each athlete in order to monitor those parameters as indirect markers of doping, based on the fact that all drug intake causes modifications in the body, that is: to look at the consequences (effects), versus to look only at the substance itself (cause). If we monitor some blood parameters like haemoglobin, haematocrit and reticulocytes, and we create an individual profile for the athlete, we can prove a doping practise regardless of the kind of prohibited substances or methods used. The same applies to longitudinal profiles of endogenous steroid parameters in urine.
All these strategies can affect the athlete's privacy rights. Some critics of the World Anti-Doping Program see this as problematic. To counter those critics, WADA implemented the International Standard for the Protection of Privacy and Personal Information. With this solution the proportionality principle is respected. It assures a balance between different fundamental rights: privacy on one side and clean sport and good health on the other.