French newspaper Le Journal du Dimanche (JDD) has come up with the sensational headline “Froome “dopé” par l’UCI” which doesn’t need much translation. Behind it is the allegation that during the Tour de Romandie Chris Froome fell ill, the team doctor wanted him to take an anti-inflammatory drug called prednisone and the UCI gave approval and that this was “rushed” with “administrative legerity”.
Prednisone is a glucocorticosteroid and here’s the WADA Prohibited List :
All glucocorticosteroids are prohibited when administered by oral, intravenous, intramuscular or rectal routes.
Prednisone is banned in competition but note the wording, banned when administered by the four routes above. Other means are permitted, for example as a topical cream applied on the skin, as a nasal spray or even certain injections.
Banned substances can be used under approved conditions and the rider/team must apply for a Therapeutic Use Exemption (TUE). The JDD is saying Team Sky applied for a TUE for the oral use of prednisone and that this was agreed “on the spot” by the UCI’s chief medic, Doctor Mario Zorzoli. The JDD says “the eventual granting of a TUE goes via a committee of medical experts” but the UCI hurried things, citing links between the UCI and Team Sky to suggest favouritism, notably UCI President Brian Cookson’s son Oli who works for Team Sky.
What the UCI rules actually say
The JDD hasn’t quite got the UCI rules right. Rule 40 of Chapter 13 of the UCI rulebook says:
The UCI shall appoint a committee of at least 3 (three) physicians to consider requests for TUE’s: the Therapeutic Use Exemption Committee (TUEC).
But this rule relates to the appointment of the committee and not necessarily the execution of its duties. For that we have Rule 45:
Upon the UCI’s receipt of a TUE application, the Chair of the TUEC shall appoint one or more members of the TUEC (which may include the Chair) to consider such application and render a decision promptly.
In this case if Sky sent in the TUE form the UCI’s committee doesn’t have to meet in full, it can appoint one individual to consider and decide the matter. It might be more sound to convene given Froome’s high profile status and the sensitivities but that’s a matter of judgement, availability and timing and not the rules.
Normally the TUE has to be applied for 21 days ahead of use. But it can be fast-tracked or even retroactively applied for if the condition is “acute”.
Aside from the rules there’s the health issue which is really what matters. If someone needs a strong medicine like this should they really be racing? Normally a doctor prescribing prednisone is going to advise rest rather than an Alpine stage race so why wasn’t the Team Sky doctor sending Froome home to rest? Professional sport is different, there are big issues at stake. Legal advantages to get the job done, be they tramadol or TUEs, are part of this in cycling and many other sports – other French newspapers have been quantifying the amount of cortisone injections (40 a year?) given to Franck Ribéry this week, treatment to play rather than the usual “have a rest”. Back to cycling and the same question was put by Lionel Birnie to Team Sky when Rigoberto Uran needed a TUE during the 2011 Dauphiné, scroll down to Stage 6 to read about what happened.
There’s also the issue of performance enhancement. Obviously this is why prednisone is banned and its use has to be regulated. There has been plenty of glucocortisteroids steroid abuse in the past and the current system of TUE’s is still open for abuse. Prednisone has a short half life so the timing of its use matters, for example a big dose prior or even during a key mountain stage or time trial could be a boost but use after such an effort and in the event of illness is quite another.
Note that in cycling the injection of glucocortisteroids under a TUE has to be followed by an eight day period of rest, Rule 13.1.065, and it’s something the likes of tennis or soccer don’t subscribe too. It’s likely there are players “doped by FIFA” in the World Cup. Just don’t expect the same headlines.
It all boils down to whether Dr Zorzoli is part of the UCI’s TUE Committee. If so then he has the authority to issue the TUE alone and on the spot. If not then there’s some explaining to do.
Beyond this there are judgement calls. Should the committee have convened? Is it suitable to race while on this medication? It’d be good to get the explanation to both but these are matters of nuance rather than scandal.
There’s also the problem for the Cooksons with UCI President Brian and son Oliver in Team Sky: Cookson Senior has the power to rule over factors that influence his son’s employer. Like the Pat McQuaid conflict of interest with the various business activities of his sons nobody should deny a right to work in pro cycling. Instead the UCI needs an effective conflict of interest management policy. McQuaid said he would “walk out of the room” which acknowledged the problem but was naive at best, as if those sat in the room would decide impartially just because the President had popped out. The UCI under Cookson is supposed to deliver more formal corporate safeguards and these need to be implemented. And seen to be implemented.
Headline doping? A topical application of cortisone might be needed for the Journal du Dimanche’s inflammatory “Froome ‘doped’ by the UCI” title. The JDD says the TUE application was “rushed” and should have gone to a panel of three experts but it turns out the UCI rules don’t state all three have to convene in order to review a TUE application. Ideally yes but in an emergency situation this would be impractical.
Behind the drama headlines there are some simple questions for the UCI to answer: if Dr. Zorzoli is part of the UCI’s TUE Committee then his lone approval is all within the rules. But if the TUE was issued in an unorthodox manner then Dr Zorzoli and the UCI have plenty to explain. Another follow-up question would be whether the UCI’s implemented new policies to manage conflict of interest concerns.
Note all translations from the JDD into English above are mine, ie unofficial
- UPDATE:the UCI has issued a press release to counter the JDD’s version of events. It’s not their finest effort:
“Christopher Froome’s TUE for oral use of glucocorticosteroids was granted on April 29, 2014 based on duly documented medical history and in compliance with the applicable UCI Regulations and the relevant WADA guidelines. The TUE was granted for a limited period, following the usual procedure.
The process was fully transparent as it is UCI’s policy to systematically record all TUEs on ADAMS. WADA was therefore informed throughout the process.
The UCI wishes to emphasise that under the applicable rules – which are consistent with the WADA Code and the WADA TUE Standard and Guidelines – any rider with the same symptoms as Christopher Froome would have received a similar TUE.
The UCI would like to express its profound disappointment with the speculations that have been made suggesting its President could have any influence on the granting of TUEs. The UCI President and the UCI Administration have absolutely no involvement with decisions on TUEs. Insinuating that Brian Cookson’s son’s employment with Team Sky could have something to do with the decision to grant the TUE is an unfounded allegation which will be dealt with seriously.”
For starters it’s full of jargon. The JDD is a Sunday newspaper for ordinary readers but the UCI’s version of events won’t register with them as Aigle serve up a steaming bowl of acronym soup with UCI, TUE, ADAMS, WADA. You might get these terms but that’s because you’ve come to a cycling blog but everyone else won’t. Even the sports editor of a newspaper looking into this might not get it.
The main failing is that it’s not a point-by-point rebuttal. The JDD has set out a story and a series of events all built around the idea that Dr Zorzoli “rushed” a TUE for Chris Froome. The UCI responds saying it followed the rules, but doesn’t say why. If the UCI tried to explain who did this and why it was within the rules (ie as set out by this blog) then it kills the story. Just saying the process was “transparent” but not explaining it to anyone leaves readers – and the media – scratching their heads or dialling the UCI for more clarification.
Note the “any rider with the same symptoms as Christopher Froome would have received a similar TUE”. Same symptoms should equal same TUE, no? Not “similar” which suggests similarity not identical. Just a drafting error but this isn’t the place for ambiguity.
Also when the UCI says “The UCI President and the UCI Administration have absolutely no involvement with decisions on TUEs” hopefully that’s correct. But involvement and influence are not the same. When someone in an organisation is tasked with taking a decision that rules over their bosses family there’s always an unconscious influence. It might be tiny but it’s there. The UCI should instead be pointing to rigorous management practices to protect against conflict of interest concerns.