SII Focus 17th September 2016

Fancy Bears hack now involves 40 athletes from 10 countries

A new leak of confidential medical data taken from the World Anti-Doping Agency’s (WADA) Anti-Doping Administration and Management System (ADAMS) has exposed Therapeutic Use Exemptions (TUEs) and Adverse Analytical Findings (AAFs) relating to 11 athletes from five countries. The data leaked by the Fancy Bears internet site now encompasses the round total of 40 athletes from 10 countries:

• USA – 14 athletes;
• UK – nine athletes;
• Germany – seven athletes;
• Australia – three athletes;
• Denmark – two athletes
• Czech Republic – one athlete;
• Poland – one athlete;
• Romania – one athlete;
• Russia – one athlete;
• Spain – one athlete.

The latest leak involves eleven athletes including three from Australia, one from Denmark, two from Germany, one from Spain and four from the United Kingdom. Although the latest leak involves one AAF, a TUE is held for that AAF, which means that it would never have progressed into an anti-doping rule violation (ADRV). As highlighted on Thursday, a TUE does not mean that an athlete, or the country or sport that they represent, has done anything wrong and there is no suggestion that the athletes involved in the latest leak have abused the TUE system in order to win. There is no evidence to suggest that the new leak of 11 TUEs relate to anything other than a genuine medical need.

As The Sports Integrity Initiative initially reported after the first data leak and WADA clarified in a statement yesterday: ‘Athletes may have illnesses or conditions that require a particular substance or method that appears on WADA’s List of Prohibited Substances and Methods (List). In such instances, they may be granted a TUE, which gives them permission to take a substance or use a method. TUEs are only granted by IFs, NADOs and Major Event Organisers (MEOs) following a robust review process that is defined in the International Standard for Therapeutic Use Exemptions (ISTUE); and, evaluation by three physicians specialised in sports medicine and/or other relevant specialties. Granted TUEs are subject to further evaluation by the relevant ADOs and WADA.’

WADA’s statement said that ‘athletes should not be forced to publicly justify their TUEs’, however speculation that foul play is at work will force them to do just that. “What they have done cannot fail to be of interest to the international community, especially the sports community”, Russian President Vladimir Putin told Ria Novosti. “There are a lot of questions. It seems as if the healthy athletes legally take medications that are prohibited for others and people who obviously suffer from serious illnesses and severe disabilities, are excluded from the Paralympic Games even on suspicion of taking drugs.”

Some of the 40 leaks involve backdated TUEs, which has led to speculation that athletes, their sport or their national federation are abusing the TUE process. However, retroactive TUEs are permitted under Article 7 of WADA’s ISTUE. WADA’s guidelines on TUEs specify that retroactive TUEs may be used where a prohibited substance has to be administered to an athlete – this includes situations where their health may be at risk.

The mere fact that a TUE is backdated does not suggest any wrongdoing. On the contrary, it is likely to mean that the athlete concerned had a medical emergency which needed treatment. The retroactive TUE process was introduced to cover situations such as the one that occurred in the 2001 Tour de France where Jonathan Vaughters was forced to withdraw, as he was unable to seek treatment for an allergic reaction to a bee sting that left him unable to see, as the corticosteroids he required featured on WADA’s Prohibited List.

Many of the TUEs contained within the leaks that relate to cycling involve the use of corticosteroids or glucocorticoids, which are often used to treat injuries. The Cycling Independent Reform Commission (CIRC) Report, published in March 2015, found that TUEs were ‘systematically exploited’ by some teams, specifically for the use of corticoids. ‘One rider who had doped reported that he was told to ask for a TUE for triamcinolone acetonide (Kenacort) claiming that he had tendonitis; he had no problem obtaining the TUE’, reads the Report.

‘One doctor stated that it was impossible to lose the weight that some riders achieve without assistance, and that the TUE is taken advantage of to enable this practice’, the Report continued. ‘He stated that riders use corticoids to “lean out” i.e. to lose weight quickly, and keep it off, without losing power. By way of example he explained that to lose 4kg in four weeks by using corticoids would provide a 7% power/weight improvement. He added that when used in large quantities and in conjunction with other substances, they supported performance gains. Another doctor stated that some quite recent big wins on the UCI WorldTour were as a result, in part, of some members of the team all using corticoids to get their weight down to support the individual who won (who also used the same weight-loss technique). It was reported that this had been a planned approach by that group’s management.’

It appears that this area may not have been entirely cleared up. “There is a lot of anecdotal evidence to suggest that cyclists are using corticosteroids in training”, Dr. Jeroen Swart – who conducted tests on Chris Froome last year – told The Guardian. “They are also used for treating injuries but I don’t think it would be an overwhelming burden if the door was closed on abusing corticosteroids for performance by extending the requirement of TUEs to out of competition. Thyroid hormone is also not on the Prohibited List but it maybe used to reduce weight and control appetite. Yet on the other side of the scale we have cannabinoids which are prohibited which don’t have any performance benefits, so the justification of what isn’t on the WADA List is not as clear as it should be.”

Asserting that an athlete has doped based on a TUE form is impossible without knowing the context in which the TUE was applied for. However, the Fancy Bears leaks appear to be intended to create speculation that rules have been abused in order to assist athletes to win. As before, The Sports Integrity Initiative takes the view that athletes are innocent until proven guilty.

Nicola Adams (UK)

Boxer Adams won a gold medal at the Rio 2016 Olympics, and documents released on the Fancy Bears internet site reveal she held TUEs which expired in 2009 for salbutamol, salmeterol and fluticasone propionate, all of which can be used to treat asthma. Her problems with asthma were highlighted when she took gold in the London 2012 Olympics. It is not known whether she was taking asthma medication at the London 2012 or Rio 2016 Olympics, or whether she held valid TUEs for any asthma medication she might have been taking.

However, a further leaked document shows that in February 2016, she held a retrospective TUE for methylprednisolone, a corticosteroid used for anti-inflammatory effects, but also in the treatment of lung conditions. The TUE was for ‘one time emergency use’.

Laura Trott (UK)

Laura Trott, a known asthmatic, won gold in the women’s omnium and team pursuit at the Rio 2016 Olympics. Documents released by Fancy Bears show she held TUEs for salmeterol (Seretide 50) and salbutamol during the London 2012 Olympics, where she won golds in the same events.

Siobhan-Marie O’Connor (UK)

O’Connor took silver in the Rio 2016 pool in the women’s 200m individual medley, and documents released by Fancy Bears show a number of TUEs for prednisolone and a 2016 TUE for the pill form beclomethasone, a steroid medication used to treat ulcerative colitis. O’Connor suffers with the bowel condition, which was undiagnosed when she competed at the London 2012 Olympics.

Olivia Carnegie-Brown (UK)

Carnegie-Brown won a silver medal in the women’s eight at the Rio 2016 Olympics. Documents leaked by Fancy Bears show that in 2009, she held a retrospective TUE for prednisolone, a glucocorticoid used to treat inflammation. Another TUE which expired in 2013 is for salbutamol, which is often used to combat asthma.

Jeanette Ottesen (Denmark)

Ottesen won a bronze in the women’s 100m freestyle in the Rio 2016 pool, and documents show she recorded an AAF for terbutaline during the Games. Terbutaline is a beta-2 agonist used in the treatment of asthma and other conditions. Ottesen holds a valid TUE for terbutaline from the Fédération Intrenationale de Natation (FINA).

“I take only the medications I need, and I have authority to take”, said Ottesen in a statement published by Anti-Doping Denmark. “I also think that it is funny that the hackers are from Russia”.

Kim Brennan (Australia)

Brennan won a gold in the women’s single sculls at the Rio 2016 Olympics. Documents released by Fancy Bears show TUEs for epinephrine (adrenaline), however they were explained by Rowing Australia. ‘Kim Brennan was administered adrenaline in an emergency department following a severe allergic reaction in January 2014’, read a statement. ‘Her Therapeutic Use Exemption (TUE) entitles her to carry an EpiPen in case of future episodes. Reports that Brennan has used adrenaline on multiple occasions, and for asthma, are false.’

“To call into question the use of a substance administered by a doctor in a hospital emergency department to combat a severe allergic reaction is beyond disappointing”, said Brennan in the statement. “This administration of adrenaline was in no way performance enhancing. I was seriously ill following this hospitalisation and I am upset I have to justify in the public domain my personal medical records. I followed all WADA procedures in ensuring I received the appropriate permissions for this treatment and strongly believe in doping free sport. The highly concerning issue here is the leak of personal medical information.”

Alexander Belonogoff (Australia)

Belonogoff won a silver in the men’s quadruple sculls at the Rio 2016 Olympics. Documents released by Fancy Bears show TUEs for epinephrine (adrenaline). ‘Alexander “Sasha” Belonogoff has a TUE which entitles him to carry an EpiPen for a severe food allergy, not asthma’, read Rowing Australia’s statement.

Jack Bobridge (Australia)

Bobridge won a silver in the men’s team pursuit at the Rio 2016 velodrome. Documents released by Fancy Bears show TUEs for prednisolone and glucocorticoids. ‘Regarding the WADA hacks + “leaks” of my personal information I’d like to make it clear I have no problem with this info becoming public’, wrote Bobridge on Twitter. ‘It is widely known that I have rheumatoid arthritis that, at times has left me barely able to grip the handlebars. I have taken appropriate medication for this terrible disease according to the UCI rules with their written permission.’

Mireia Belmonte Garcia (Spain)

Belmonte Garcia won gold in the women’s 200m butterfly at the Rio 2016 Olympics. Documents leaked by Fancy Bears show she held a TUE that expired in 2013 for asthma drug salbutamol, granted by the Fédération Internationale de Natation (FINA).

Julian Justus (Germany)

Justus took part in the shooting competition at the Rio 2016 Olympics. Documents released by Fancy Bears show he held two TUEs for budesonide, which have since expired. Budesonide can be used to treat a number of conditions including asthma, bowel problems, ulcerative colitis and Chron’s disease.

Laura Siegemund (Germany)

As well as competing at Rio 2016, Siegemund has won three doubles titles on the WTA Tour, as well as 11 singles titles and 20 doubles titles on the International Tennis Federation (ITF) circuit. Documents released by Fancy Bears show that she held a TUE for formoterol and salbutamol, expiring in 2013. Both drugs are used in the management of asthma.

Reaction

The release of the documents was widely condemned as a privacy breach by the NADOs and sporting federations concerned. “It is incomprehensible that someone would use athletes’ personal information to try to undermine the global anti-doping system.”, said UKAD’s CEO, Nicole Sapstead. “These athletes have obtained TUEs through a robust and independent system. The use of TUEs is not a doping offence, and all of these athletes have legitimately applied for, and been granted, medical support within the anti-doping rules.”

When five German athletes were targeted on Thursday, its National Anti-Doping Agency (NADA) hinted that a criminal investigation was underway. This appears to be progressing. “We have made contact with the authorities responsible for prosecuting cybercrime in Cologne via the BKA [the Federal Criminal Police Office], the Customs Office and it has been given priority by the Munich prosecutor’, read a NADA update.

WADA has already confirmed that the information was accessed via an International Olympic Committee (IOC) account for the Rio 2016 Olympics. However, NADA Germany has been in contact with WADA, and was told that despite WADA’s firewall being attacked ‘more than 15,000 times in recent days’ without success, the ADAMS system remains otherwise secure.

“Anti doping is a mutual obligation system”, said Richard Ings, former CEO of the Australian Sports Anti-Doping Authority (ASADA). “Athletes agree to onerous requirements on any time anywhere provision of blood and urine samples. Anti doping organisations agree to protect athlete privacy. The issue surrounding this hack of medical information is not about TUEs. I have not seen a single hacked TUE that raises any issue of illegitimate approval. The issue here is a failure of anti doping agencies to comply with their fundamental and non negotiable obligation to protect the athlete medical records they are entrusted with.”

As The Sports Integrity Initiative reported on Thursday, the Office of the Privacy Commissioner of Canada is awaiting a response from WADA about the leak of the documents, which appears to represent a breach of athlete privacy. If it is found to have failed in its obligations to keep confidential athlete data secure, WADA could face sanctions. It could also face legal action from athletes.

Who are the Fancy Bears?

As The Sports Integrity Initiative has previously reported, the only evidence that links Fancy Bears to Russia is the similarity in name to a cyber-espionage group Fancy Bear, which has been in existence since 2008. The IP address for the Fancy Bears internet site can be traced to the US and a French physical address is also listed. Every WADA release since the first hack has blamed Russia for the leak of the documents.

The site has focussed on athlete TUEs from countries such as the USA, the UK and Germany. Russia has reason to specifically attack these countries, and the focus on TUEs from ’western’ countries rather than China, Kenya or India, for example, could lead to speculation that Russian forces are at work.

Through the Partnership for Clean Competition (PCC), the major US sports were involved in commissioning research which led to the inclusion of meldonium – a drug commonly used in Russia – being included on the Prohibited List. The UK could be a target as UKAD is working in Russia to test its athletes, and complained that it was not being given free access to test athletes. Germany could also represent a legitimate target, as the home country of Hajo Seppelt, the journalist who did much to expose systemic Russian doping.

However to suggest the involvement of the Russian State in such a clumsy method of attacking WADA, when such a clear motive exits, perhaps does the Russian State a disservice. WADA has emphasised that the data that can be accessed is confined to athletes that competed at the Rio 2016 Olympics. As such, NADOs and National Olympic Committees will have to warn all Rio 2016 athletes that their confidential data remains at risk.

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