What is a Therapeutic Use Exemption – “TUE”?

Athletes, like all people, may have illnesses or conditions that require them to take particular medications or undergo procedures. If the medication or method an athlete requires to treat an illness or condition happens to fall under the Prohibited List, a Therapeutic Use Exemption (TUE) may give that athlete the authorization to take the needed medicine or method. TUEs are granted according the International Standard for TUEs (ISTUE), a document outlining the conditions, the stakeholder responsibilities and the TUE process. 

The ISTUE is the reference standard for the South African Institute for Drug-Free Sport (SAIDS) TUE application process.The definitions outlined below comply with the ISTUE.

Who needs to apply for a TUE in advance?

The athlete’s level i.e. whether he/she is an National Level or International Level Athlete is important in determining when they need to apply for a TUE (in advance or retro-actively).

Click here to read the important information to understand whether you are classified as a National, International Level Athlete or Other Athlete and what steps to follow to apply for a TUE.

What are the criteria for granting a TUE?

NOTE: the criteria are the same, whether you apply in advance or retro-actively.

The criteria are:

  1. The athlete would experience significant health problems without taking the prohibited substance or method;
  2. The therapeutic use of the substance would not produce significant enhancement of performance;
  3. There is no reasonable therapeutic alternative to the use of the otherwise prohibited substance or method;
  4. The requirement to use that substance or method is not due to the prior use of the substance or method without a TUE which was prohibited at the time of use.

For the TUE to be granted, all four criteria must be met.

TUE Application Process

  • Contact SAIDS or the relevant International Federation (IF) (whichever applies) and ask for information about the TUE Application process.
  • The TUE application form should be filled out and signed by a physician and the required supporting documentation provided and forwarded to SAIDS or the IF (whichever applies) for approval.
  • To submit the TUE application to SAIDS please use the following contact details:
      • TUE Administrator at rado-tue@saids.org.za.
      • Or contact the SAIDS head-office for any further information on 021 686 1634.
  • Athletes should remember that the TUE Application should be submitted at least 30 days before participating in an event.

Tips on applying for a TUE:

  • Complete the form – either typed or handwritten in block capital letters. If the form is not legible, it is deemed incomplete and will be returned to the athlete.
  • If faxing the form, ensure that you include all the required documentation and keep a copy of the request as well as a record of the transmission or acknowledgement of receipt.
  • Ensure that your TUE application is complete with all the medical information, tests, laboratory results, imaging studies, clinical information to enable the TUE Commission (TUEC) to reach a decision in tune with WADA’s documents entitled “Medical Information to Support the Decisions of TUECs/TUE Physician Guidelines” available here. Upload all of your medical information to support the use of the prohibited method or substance.
  • Please use the checklist for your medical condition (see the Downloads section on the right) to guide you with regard to the required content of your TUE application file. This is a tool provided by SAIDS and WADA to assist athletes and their physicians with their submission. However, please note that a completed application and checklist DO NOT guarantee the granting of a TUE.
  • Any TUE application requires a current medical report that should not be older than six months to ensure that athletes are regularly monitored.
  • Always keep a copy of all your medical information, especially the initial diagnostic together with laboratory results, imaging studies and physicians’ notes.