WADA hack raises questions about therapeutic use exemptions, security

In releasing private medical information about dozens of Olympians over the past week, the Fancy Bears hack team has sought to reveal “dirty methods” by which athletes — specifically Americans — win their medals.

But Fancy Bears, which the World Anti-Doping Agency has said is a Russian cyber espionage group, has likely fallen short of that goal, experts agreed. Rather, the hackers have exposed other cracks in the anti-doping system — namely a lack of transparency around therapeutic use exemptions (TUEs) and concerns about WADA’s ability to protect athletes’ information.

Those concerns come at a fraught time for anti-doping, as the last year has also included two investigations that revealed widespread and state-sponsored doping in Russia. Investigators found tampering during the 2014 Sochi Olympics, compliance issues in several laboratories around the world and a lack of consensus between WADA and the International Olympic Committee as to how the system should be reformed.

“It’s the sort of thing where yeah, if the Fancy Bears’ target was to create a scandal around American athletes, probably it missed because there’s nothing really too exciting there,” said Roger Pielke Jr., a professor in the sports governance program at the University of Colorado.

“Maybe ironically, the Fancy Bears have hit another target, which is to show that the same flaws in anti-doping oversight that led to the Sochi lab and so on show up here as well in the protection of athletes’ data, lack of transparency. It kind of reinforces the problems surrounding the whole Russian episode.”

Fancy Bears released its fourth dump of data taken from the WADA database on Monday, bringing its total to records on 66 athletes from 15 countries. The United States and Britain account for 35 athletes on the list.

Many of the records are for therapeutic use exemptions, which athletes can get to allow them to take a substance on the banned list.

But it’s not always an easy process to get one. Athletes must provide medical justification from a doctor, and that information is reviewed by a TUE committee that either accepts or rejects the application. Those TUEs are time-limited, meaning an athlete might take a medication during the course of an illness or injury or be granted a longer TUE for a chronic condition.

Many of the medications for the TUEs released by Fancy Bears — most of which are several years old — are for the treatment of conditions like asthma or ADHD.

While some of the information released by Fancy Bears included positive tests from the Rio Olympics, the IOC and U.S. Anti-Doping Agency have said that the four Americans included in the initial release last week — including gymnast Simone Biles and Venus and Serena Williams — have done nothing wrong.

“In terms of the exemptions themselves, they’re completely non-remarkable,” said Richard Ings, the former CEO of the Australian Anti-Doping Authority. “There’s nothing that’s raised my eyebrows, and I’ve seen a lot of these things.”

 

Cracks in the system

Fancy Bears’ site says it views these documents as “licenses for doping” granted by WADA, which it sees as corrupt.

None of the experts who spoke to USA TODAY Sports supported that, but all said greater transparency would help anti-doping organizations.

Most supported the release of aggregate data so that trends, such as the prevalence of a certain drug in a sport or of a large number of exemptions per country, could be spotted.

But anti-doping organizations — which include those for nations as well as international federations that govern each sport — are not required to release those. WADA, for instance, did not respond to messages from USA TODAY Sports for information on TUEs it reviews.

Some agencies do release information, however.

The U.S. Anti-Doping Agency granted 136s TUEs for athletes in a registered or international testing pool in 2015. USADA spokesman Ryan Madden said 15 Americans competing in Rio — or roughly 2.6 percent of the 558 athletes on the team — had a current TUE.

The International Tennis Federation said it grants TUEs for about half of the approximately 100 applications it receives per year. FINA, which governs swimming, said it reviewed 29 applications in 2015.

UCI, which governs cycling, publishes its number of TUEs, with that total declining to 15 last year from 239 in 2009.

“If you look at a TUE application, they’re not for the faint of heart,” said Joseph de Pencier, founding CEO of the Institution of National Anti-Doping Organizations.

“I think one of the messages coming out of these leaks is that it shows that in fact, we’ve got a very robust system.”

Part of the problem, experts said, is the number of banned substances with more than 300 on the list. As more and more substances are added — sometimes with minimal evidence of their performance enhancing benefits, as WADA has seen in its ban of meldonium — the concerns over the number of TUEs granted is likely to increase.

“The list is too damn big because if you have a list of 300 substances and growing and many of the things on the list are legitimate medications that people take, and you factor in we don’t know the performance-enhancing effect of many, if not most, of the substances on the list, really, we’re shadow boxing,” said Pielke. “We’re getting outraged over athletes who are getting exemptions to take legitimate medications for which we have no clue what performance enhancing benefit they may be getting anyway.”

On Twitter last week, the Russian Embassy UK’s official account argued with a BBC reporter that use of banned substances should not be kept secret.

Experts said anti-doping organizations have to walk a fine line between transparency and the right to privacy.

David Larkin, an international sports attorney, said maybe designating which athletes have been granted TUEs without revealing their medical information would help.

“If we’re gonna live in a world where Justin Gatlin is deemed to be a serial doper because he was first flagged for Adderall use and yet at the same time, other athletes with TUEs use the very same substance and are then deemed to be above board, it seems like the system doesn’t work very well and then the system has some real fundamental problems that need to be addressed with regards to TUE use and prohibited substance designation,” he said.

Few doubt that and can point to examples on either side.

Lance Armstrong was able to obtain a TUE retroactively — a process which is allowed under WADA rules — to cover up doping.

But fellow cyclist Jonathan Vaughters had to drop out of the Tour de France in 2001, before the current anti-doping structure was in place, after an allergic reaction to a bee sting caused his face to swell and he was not allowed to take an injection to help it.

“We’ve seen so many cracks in the anti-doping system that there’s bound to be some cracks in the TUE system,” Ings said. “But this shouldn’t be about throwing out the entire system. There needs to be a process of allowing athletes to get medical treatment.”

 

Calls for reform

Of equal or even greater concern is that hackers have been able to access athletes' private medical information.

The leaks from Fancy Bear are at least the second hack of the WADA database in the past two months. Russian whistleblower Yuliya Stepanova provided much of the information that formed the bases of a WADA-commissioned report released in November and resulted in the country’s track and field team being banned from Rio.

Because she is continuing to compete, she must enter her whereabouts information with WADA so that she can be drug tested. After that information was accessed last month, she and her family moved to a new location within the United States, where they have lived since fleeing Russia in 2014.

“It’s really unfortunate for the individual athletes to have to go through this,” said Pielke. “They should be pretty well upset that their data wasn’t protected.”

Some, like Biles, have addressed it head on. She tweeted about her diagnosis of ADHD after the hack revealed positive tests for a drug to treat the condition during the Olympics.

German discus thrower Robert Harting tweeted, “Me and the medical staff are fine with the leaked content. We don't hide anything. go transparency!”

Russian sports minister Vitaly Mutko has denied a link to the hackers, saying at the UEFA Extraordinary Congress that “it’s very in fashion now” to blame Russia.

Russian President Vladimir Putin said he did not approve of the actions, but said it revealed “that people, who took part in the Olympics and looked absolutely healthy, had taken banned medicines giving them an edge in competition,” according to the Associated Press.

But experts agreed to boil these issues down to Cold War-esque attitudes is to miss the point.

“This whole episode pushes back at the idea that there was an aberration in the Russian system, that there’s more systemic, deeper issues,” Pielke said. “To that extent, the narrative is going to be if this is a Russian-motivated hack, it reinforces the Russians versus the world sort of thing. If we’re smart, the people who are paying attention, then this is a great opportunity to get the anti-doping house in order so that the Russian/Sochi lab thing doesn’t happen again and so that athletes’ data is better protected and so that anti-doping is more transparent.”

Indeed, the hack falls in line with a series of issues for anti-doping.

In the past year, WADA has been criticized for being slow to investigate Russia, for inadequate compliance review of national anti-doping organizations and labs and for conflicts of interest of its leadership.

So accepted is the notion that the system is faltering, if not broken, that WADA and the IOC are holding separate discussions this month and next on how to reform it.

Fancy Bears seemingly hoped to reveal hypocrisy in Americans being allowed to cheat while Russians are punished. Instead, it added the granting of TUEs and the failure of security to a list of issues facing anti-doping officials.

“In the last 12 months, the system has been faced with its worst-case scenarios — theft of confidential information, allegations of state-sponsored doping,” said Ings. “And the system has been found wanting. This needs to be a system that can handle worst-case scenarios, and if it’s failing so badly to handle these worst-case scenarios, then it needs to be retooled and it needs to be strategically reviewed and it needs to be reformed.”


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