High Altitude And High Stakes: A Recent Anti-doping Appeal To CAS

This insight explores the nuanced and sometimes harsh reality of punishments for anti-doping offences. Recent cases highlight that players must be acutely aware of their bodily integrity and ensure to protect themselves against ingesting any banned substances, even those that may be prescribed to them by their own team doctors. 

Background

Boris Cespedes is a Bolivian professional footballer, who was 29 at the outset of the 2024/2025 season and played for Yverdon-Sport FC of the Swiss Super League. On 18 March 2025, Cespedes reported for international duty with the Bolivian National Team (FBF), set to play in two FIFA World Cup qualifiers against Peru on 21 March 2025 and Uruguay on 25 March 2025. The team arrived in Peru on 18 March 2025 with the match due to take place in a venue at a high altitude. As a result of this, the player claims that on 21 and/or 22 of March 2025, he was prescribed altitude sickness medication by the team doctor. 

On the following day, and shortly after arriving in La Paz, Bolivia, the player was treated for gastroenteritis and prescribed antibiotic injections by the same team doctor. Cespedes continued to take the prescribed altitude sickness medication. Although he did not take part due to illness, Cespedes was named in the matchday squad against Uruguay on 25 March 2025. 

Following this match, he was selected for in-competition doping control and provided a urine sample, which on 14 May 2025 was confirmed to contain a Specified Substance classified under Category 5 (diuretics and masking agents) of the World Anti-Doping Agency (“WADA’”) Prohibited list, namely Acetazolamide (a common example of which is Diamox). 

Initial Proceedings – FIFA Disciplinary Committee

As this was a football competition governed by FIFA, it fell to that governing body to deal with the matter in the first instance. The FIFA Disciplinary Committee (“FDC”) issued its full decision (FDD-23720) on 17 September 2025, finding the following:

1. That Cespedes had committed an Anti-Doping Rule Violation (“ADRV”) being the presence of a prohibited substance in his body. Article 6 of the FIFA Anti-Doping Regulations 2021 (“FADR”) applies strict liability(1), which was not contested by the player;
2. That the ADRV was not intentional, meaning Article 23.1 of the FADR applies, imposing a starting point of a two-year period of ineligibility;
3. That Cespedes failed to adequately and with sufficient clarity, establish the source of the prohibited substance;
4. That a two-year period of ineligibility would be imposed. 

The decision did take note of Cespedes’ clean record, and while the player’s age and impact on his career were noted, the FDC stated that they could not take age or career prospects into account during these disciplinary processes. 

Appeal to CAS

Cespedes appealed this decision to the Court of Arbitration for Sport (“CAS”), seeking for a new decision to issue, imposing a suspension of Cespedes for a period of no more than six months. 

Cespedes submitted that he had been prescribed medication containing the prohibited substance for altitude sickness by one of the two official team doctors. Cespedes contended that the responsibility for ensuring all prescribed medications do not contain prohibited substances rests with the team doctor and the doctor alone as a medical professional. 

It was also submitted that Cespedes had provided explanations to FIFA of what the prohibited substance was and how it had come to be found in his body. However, the requirement on the player to identify the exact medication, in circumstances where the appropriate doctors, along with the FBF (‘Bolivian Football Federation’) governing body refused to co-operate, is an impossible burden of proof to overcome. 

Cespedes had submitted evidence that included WhatsApp messages, telephone records and an interview recording which demonstrated that the team doctor administered the altitude sickness medication to Cespedes. 

Cespedes claimed that his degree of fault was minimal and relied on mitigating factors such as his clean history, ill health at the time and reliance on the team doctors’ assurances as proof that he took every reasonable step. As such, Cespedes contended that Article 20 of the FADR should apply, permitting a reduced sanction where the athlete bears no significant fault. 

FIFA however relied on Article 6 of FADR, imposing strict liability. The mere presence of acetazolamide in Cespedes’ urine sample constitutes an ADRV and therefore a period of ineligibility must apply. They did acknowledge that the ADRV was not intentional and therefore applied a two-year period of ineligibility in line with Article 23.1 FADR. 

FIFA was critical of Cespedes in that he had:

1. Failed to properly identify the source of the prohibited substance, such as the name of the medication prescribed;
2. Failed to produce any medical record, prescription form or document of any kind confirming that altitude sickness medication had been prescribed;
3. Not listed any altitude sickness medication on his Doping Control Form (DCF) which accompanied his sample. 

FIFA argued that Cespedes had fully delegated his declaration on the DCF. Within Section 4 of the DCF, the subjected athlete must declare that all information contained in the form is correct(2). Cespedes is therefore himself responsible for the omission which exceeds reliance on a doctors’ assurances and ‘reflects a delegation of a core anti-doping responsibility that the athlete is not entitled to devolve’(3).

It is for this reason that FIFA found that he did not meet the threshold of no significant fault, as he had a responsibility for all substances entering his body. 

Appeal Findings

On 8 June 2026, the CAS Arbitrator held that Cespedes had proven, on the balance of probabilities, how the acetazolamide had entered his system. Satisfied with the evidence provided by Cespedes, the arbitrator found that to require Cespedes to provide documentation proving the exact medication prescribed, in circumstances where both the team doctors and the FBF itself refused to cooperate, would be a burden of impossible proof. 

The Arbitrator did however concur that the player’s failure to review the DCF before signing the athlete’s declaration was detrimental in attributing fault to him. His familiarity with doping control regulations over the span of a twelve-year career, ensuring that the player was well aware of the normal procedure and his responsibility, precludes the finding of no significant fault as sought. The player has a duty to ensure that he complies with anti-doping regulations, with the arbitrator finding that Cespedes had completely delegated this duty to the team doctors, to his detriment. 

While there were mitigating circumstances, such as the player’s illness at the time and the abandonment by his national federation in dealing with the disciplinary process, the arbitrator found that there was a “normal” degree of fault, partly allowing the appeal. 

The ineligibility period was reduced to a total of 15 months, giving credit for the period of ineligibility already served since 14 May 2025. 

The initial decision made a severe impact on the career of Cespedes, as he was released by his club, Yverdon-Sport shortly after his period of ineligibility had commenced. The significant period of ineligibility deprived him a full year of his career. Following his successful appeal to the CAS, the appeal decision ensures that only one season would be missed due to ineligibility. 

According to Article 30(2) FADR, Cespedes is eligible to train with a club within the last two months of the period of ineligibility and has now returned to football at a new club at the age of 31. 

While the partially successful appeal has saved one year of his career, the lack of responsibility shown for his own DCF resulting in an ADRV has cost him one year. Cespedes, heading into the tail end of his career, ought to have been aware of his responsibility to identify every substance that enters his body. Both WADA and FIFA expect players to be accountable in such circumstances, and this decision, including the appeal confirm that a player/athlete cannot delegate the personal responsibility for what enters their system. 

Comparative scenario

Similarly, a national team teammate of Cespedes, Ramiro Vaca, was also suspended following an ADRV during March of 2025. Vaca’s sample tested positive following a match he had played with his club Bolivar, against Sporting Cristal in the Copa Libertadores. The sample tested positive for Ostarine, which belongs to a category of PEDs (“Performance Enhancing Drugs”) known as SARMs (“Selective Androgen Receptor Modulators”). This category of drugs mimic the effect of anabolic steroids, stimulating muscle growth and mass retention. 

While objectively a potentially more sinister or less ‘innocent’ offence than that of Cespedes, Vaca was able to prove that the traces of Ostarine had come from a cross contamination with his legal supplements. As Vaca was tested following a match for his club, CONMEBOL (the South American Football Confederation) rather than FIFA conducted the disciplinary hearing, as such Articles 6 and 7 of the CONMEBOL Anti-Doping Regulations applied. 

The direct indication of how the banned substance entered the player’s system was instrumental in allowing a reduction of the ban to 8 months rather than the potential 24 months that could have been applied. This is in contrast to that of Cespedes, who could not give such an indication as to how the prohibited substance entered his system. This demonstrates the earnestness and diligence that a player must apply to the documentation, recording and testing of any substance that enters their bodies. 

Key Takeaways

1. Anti-doping is a serious matter with severe ramifications for athletes – athletes and players should bear this in mind whenever they are presented with medication or supplements.
2. Athletes and players are ultimately responsible for what substances enter their bodies. 
3. The completion of a Doping Control form is a serious matter and the individual athlete/player is responsible for the declaration they make in signing the form. 
4. Strict liability applies to ADRVs and any appeal to reduce a period of ineligibility will need to be fortified by sufficient evidence. 
5. Good cooperation of a national federation and their medical team can be imperative in any appeal regarding an ADRV by an athlete/player.