Doping control from a global and national perspective.

The practice of enhancing athletic performance through foreign substances was known from the earliest Olympic games. In 1967, the International Olympic Committee (IOC) established a Medical Commission responsible for developing a list of prohibited substances and methods. Drug tests were first introduced at the Olympic winter games in Grenoble and at the summer games in Mexico City in 1968. In February 1999, the IOC convened the World Conference on Doping in Sport in Lausanne, Switzerland. The Lausanne Declaration on Doping in Sport recommended creation of an International Anti-Doping Agency. The World Anti-Doping Agency (WADA) was formed in Lausanne, Switzerland on the basis of equal representation from the Olympic movement and public authorities. One of the mandates of WADA was to harmonize the Olympic antidoping code and develop a single code applicable and acceptable for all stakeholders. The world antidoping code developed by WADA included creation of several international standards (IS). The purpose of each IS was harmonization among antidoping organizations. The ISs were developed for laboratories, testing, the prohibited list, and for therapeutic use exemptions (TUE). The objective of this manuscript is to present a brief history of doping in sport and describe creation of WADA in 1999. The components of the World Anti-Doping code (in particular, the Therapeutic Use Exclusion program or TUE) is described. The WADA code defines a TUE as "permission to use, for therapeutic purposes, a drug or drugs which are otherwise prohibited in sporting competition." Experiences of the Canadian Centre for Ethics in Sport Doping Control Review Board are presented because this national TUE committee has been operational for over 12 years. The challenge of developing a rigorous global antidoping program requires acceptance of doping as a problem by sport organizations, athletes, and public authorities. Individual stakeholders must be prepared to preserve the values of sport, which means free from doping. This will require vigilance by all interested parties for the benefit of elite athletes and society overall.