• or NPCs in education and implementation of policies and national resources for intensified testing
• for WADA in the areas of out of competition testing, support to developing countries, and support to general anti-doping initiatives in sports for athletes with a disability,

• That Athletes with a disability should have the benefit of the same anti-doping programmes as other elite athletes sooner rather than later. The overall goal is to have greater parity between Paralympic and other sports. In order to make considerable progress for Paralympic anti-doping efforts, a more comprehensive approach to doping for athletes with disabilities is necessary, including out of competition testing.
• Its support for the World Anti Doping Code (the Code) being accepted by the Paralympic Movement, and

• That
  -IPC/NPC should be included whenever IOC/NOC are mentioned in the Code *
  (* the responsibilities of IPC include dual roles, i.e. the ParalympicGames and as an IF for sports under IPC governance)
  -IPC should require from NPCs to implement on national level anti-doping policies and programmes as a requirement to compete in Paralympic Games
  -IPC should take a leadership role in communicating with all NPCs to initiate action with the aim to assist nations in complying with the Code.

• by Governments, National Anti-Doping Agencies (NADA), National Sports Confederations / NOCs, and NPCs to:
  - educate relevant personnel in the particulars in doping testing of athletes with disabilities,
  - include athletes with disabilities in national doping test programmes,
  - encourage research in doping in sports for athletes with disabilities.

- review the IPC Medical & Anti-Doping Code according to the recommendations of the Congress,

- establish an out-of-competition programme in cooperation with WADA, and

- provide leadership and assistance to the NPCs and other affiliates for them to comply with the Code;

• IPC to catalogue the needs for assistance to NPCs in order for them to comply with the Code.
• Recognising that there are obstacles to compliance of the Paralympic movement (lack of sufficient resources, different levels of compliance, etc), flexibility is crucial.
• Development of agreed standards for compliance with the Code and an agreed process of monitoring/auditing organisations, and that these agreed standards to be part of the Code.
• The requirement in the first draft of the Code for commitment to comply with pre-determined deadlines might need to be reconsidered in order to allow for differences in the ability for adopting and applying the Code.

• Education of athletes, staff, medical personnel and other athletes support personnel in the Code should be organised.
• Co-operation for NPCs and NOCs regarding education should be formalised.
• Educational material on the specifics in doping control requirements for athletes with disabilities should be initiated by EPC and IPC and provided to NPCs for dissemination to national anti-doping agencies.

• Increase out of competition doping controls in the Paralympic Movement.
• At a minimum there should be requirements to test athletes out of competition before Paralympic Games.
• IPC or WADA could weigh their testing programmes to countries with no/less developed programmes.
• While the perceived major differences between testing athletes with disabilities versus able-bodied athletes are exaggerated, standards and models of best practice to be developed must take into account disability specific issues.

• IPC and NPCs should be included in the reporting of athletes with disabilities who tested positive, and WADA will be informed automatically. This will require generic doping control documentation.
• WADA ought to establish a Clearing House for all testing, including IPC/NPC.

• Possible differences in anti doping rules between NADA/NPC and IPC need to be assessed and monitored.

• There is a need for further reflection on the use and scope of optional sanctions and sanctioning of sporting bodies.
• Should sanctioning of sporting bodies be considered, the following should apply:
  -An official warning should always be issued before the sanction.
  -More accurate definition of "repeated violations" is needed.
  -All violations under article 8.1.1. in the Code should apply.

• Any assistance that increases understanding is a very positive first step. Communicating and education about the purpose and content of the Code is essential.
• Avoid re-inventing the wheel. Adapt successful programmes or materials to suit different needs in other countries.
• IPC should catalogue the needs for assistance; such needs may be for expertise, for policies, for sample collection or analysis or for financial assistance.
• Match countries that can provide assistance for those specific needs.
• Experienced NPCs should mentor other NPCs that need help and countries with well-developed programmes should seek partnership on testing in other countries.
• Testing international bodies i.e. IPC or WADA could weigh their testing programmes to athletes from countries with weaker programmes.

• Research is needed on understanding doping by athletes with a disability (is it different from able-bodied elite athletes, same substances, same sports and events, same nationalities, same motivation for the use of doping?).
• Research is needed on boosting [technical term -autonomic dysreflexia].
• Co-operation of sports research and other research should be sought, especially in the area of genetic manipulation.
• Research results to be published widely in different languages and to be easily accessible on web sites.

• In referring to the assumption that in general, countries are willing to comply with the Code but may in some cases have no funds available to set up a comprehensive national anti-doping programme, the question was raised whether WADA would provide financial assistance for countries to comply with the Code. It was reported that WADA recognised the need for assistance to comply with the Code and intended to act as facilitator for various projects such as solidarity campaigns and a partnership programme. However, financial assistance from WADA itself was not likely.
• On the question how WADA intends to monitor compliance with the Code, it was reported that WADA is presently studying how to implement a monitoring process. It was indicated that a checklist would be developed. Together with the organisation concerned, WADA will evaluate every point on that list and monitor compliance, step by step. The monitoring process will take place in close co-operation with the organisation concerned. Reference was further made to the possibility to appeal to CAS against any decision.

• In observations made during WADA Independent Observers´ Programme during the 2002 Winter Paralympic Games in Salt Lake City, it was reported that the athletes' did not question or challenge the doping control authorities even when obvious mistakes were made. As this points to lack of education and awareness of the rules, an appeal was made for more education and for promoting self-advocacy of athletes.
• The observation was made that the Paralympic movement has presently no athletes who radically advocate for a drug free environment like is the case in sports for able bodied. It was stated that Paralympic athletes must be encouraged to talk about the importance of a drug free environment.
• On the question on the quality of the IPC doping testing system and procedures as experienced by the WADA Independent Observers programme conducted during the Paralympic Games in Salt Lake City, Mr. de Pencier confirmed that IPC and its athletes can rely on having an effective and good doping control system in place. The IPC recognises that athletes desire more testing to be done.

• It was reconfirmed that also the article 8.9.2 of the first draft of the Code concerning the right to appeal to CAS should be made applicable to the IPC and the respective parties within the Paralympic Movement.
• On the question raised whether the Paralympic Movement has any role to play in nominating individuals to the CAS panel of arbitrators, it was reported that there are no provisions in the current rules that allows IPC to nominate arbitrators for appointment to the CAS panels. Mr. Reeb suggested that IPC might wish to consider making such recommendation to CAS.

• On the question on what basis WADA is developing the list of banned substances, it was reported that WADA had submitted a first draft to the IOC. As a first step WADA had only considered performance-enhancing drugs, however, in the future also other aspects such as the effect on health, will be taken into account.

• The question was raised whether IPC has any control over NPCs to evaluate their commitment for doping testing in the own country? It was recognised that although according to the IPC Medical Code, NPCs are required to develop an anti-doping policy, there is no structure in place that allows IPC to control compliance to this requirement.
• It was recognised that in most cases national sports organisations have to comply with anti-doping programmes imposed by their respective Government and that in many cases in Europe the NPCs are included in those national programmes. However, IPC does not know how many NPCs world-wide that are part of, and included in the national mandatory requirements for anti-doping programmes. NPCs are comparable to national sports organisations, they are NGO's receiving government support and should therefore have to comply with national legislation on doping. It was confirmed that it would be the most natural thing for an NPC to turn to the NADA or to the National Sports Council/NOC, rather than to IPC. IPC should encourage national doping agencies to include NPCs and national organisations for sports for athletes with disabilities in their programmes. Neither IPC nor the NPCs have the resources to set up separate national programmes. Testing of athletes with disabilities must be included in the NADA policies and programmes. In addition, a better link between the National Sports Confederations/NOCs and NPC must be established to co-ordinate national doping programmes.

a)Ownership and governance of the Paralympic Games,

b)Governance of 14 different sports/disciplines of which many but not all also are Paralympic sports.

(Discussion about future structure changes indicates the possibility that the governance of sports may be removed from IPC responsibility.)

i.)IPC,

ii.)International member organisations (IOSD) of IPC governing different disability categories,

iii.)International Federations for a specific sport for athletes with disabilities (Paralympic IFs),

iv.)International Sports Federations (IF) with sections for athletes with disabilities (Olympic IFs).

• IPC & NPCs must be mentioned throughout the Code and reference must be made in the Code to the double role of IPC acting also as an IF.
• With regard to that dual role of IPC it must be evaluated whether there are any legal implications when conflicts of interest arise for IPC acting as both a judge and prosecutor. Does IPC have the legal basis to act in dual roles? Does that reflect abilities to separate both responsibilities?
• It was understood that the Compliance standard is based on the roles and responsibilities of the different parties. The question was raised whether IPC is expected to comply with both standards for both its dual roles. IPC should provide WADA with input on what the perceptions of its role is, and compliance to the Code should be compatible with IPCs present responsibilities. If those responsibilities change in the future, and a new structure is established, the necessary adaptations to comply with the Code will have to be made at that time.
• It was reported that within the UK research had been conducted on the need to modify testing procedures. The finding was that there are very little differences between testing able-bodied and testing disabled athletes. The different needs were identified and procedures had been outlined and published in a leaflet; all information had been made available on website. Training was offered to doping officials and an education strategy was developed both for able-bodied and disabled athletes. Delegates recognised that this was an example of good practice that could be adapted and implemented in other countries.
• Although the workshop group had lacked the time to discuss the Medical Advisory Process (MAP) it was recognised as being very important. The MAP gives the opportunity for an athlete to apply for exemption for taking a forbidden drug for medical reasons. In connection to relevant articles in the Code dealing with granting exemptions, reference should be made to the MAP process and procedures. The differences must be clearly outlined (disability/age) that lead to differences in use of therapeutic drugs. IPC should inform WADA that it will establish standards for therapeutic use.
• Reference was made to the overall willingness of the Paralympic movement to comply with the Code and to the difficulties that will raise in trying to comply with the Code within the set timeframe. It was suggested that WADA may need to reconsider going back to the original concept and have three levels of commitment to the Code; this to recognise the different capacities to adopt and apply the Code (levels ranging from a commitment in principle, to a level of full compliance with the Code).

• In respect to the sanctioning of sporting bodies and the statement that innocent athletes should not be punished, it was questioned whether fines could be considered as a fair alternative to sanctioning participants. It was suggested that levying fines may on the contrary be the least fair way of sanction because paying the fine would not be a problem for rich sporting bodies whereas for other federations finding the funding for the fine could be a major problem and block their future development.
• It was stated that the term "repeated violation" used in the Code need to be clearly identified. It was reported that there is presently no consensus among the IFs on what the number of violations should be to identify the term "repeated violation".

• The importance was stressed that full understanding of the Code and its implications should be assured for countries to be in a position of complying with it. Official translation in several languages is needed. The suggestion was made for WADA to consider other publication styles to meet the needs of persons with disabilities e.g. audio-tapes/high visibility format.
• There was consensus that making compliance with the Code a requirement, is the right road to take. The Code should be prescriptive. However, assistance and positive measures are needed rather than enforcement.
  

• The need for a co-ordinated approach in providing assistance with the aim to eventually achieve compliance by all member nations was stressed. Rather than each country building up its own partnership or mentor programmes IPC or its Regional Committees must take on that co-ordinating responsibility and facilitate this process. IPC cannot implement this from the top down, it must be an interactive process with NPCs sharing the work with others.
• It was reconfirmed that co-ordinating activities with national authorities is the most efficient way. An appeal should be launched to Governments, NOCs and NADAs to assist in the process and ensure equal treatment for able-bodied and disabled athletes. (cfr Bratislava declaration 2000 by East European nations)
• The importance was stressed to educate athletes on doping policies and procedures and to include education on health and ethical aspects. In closing the session it was mentioned that it is more useful to invest money into education rather than into dope testing.

http://www.icsspe.org/portal/texte/area/bulletin/

Congress for Harmonisation of Anti-Doping Policies and Procedures in European Sports for Athletes with Disabilities - Conclusions and Recommendations

Hans Lindström, Swedish Sports Organisation for the Disabled