Two senior experts with decades of experience in both sports medicine and politics in International Federations provide their views on the challenges, achievements and future directions for colleagues across sports.

Professor Gerard Saillant is a leading orthopaedic surgeon who has been involved in sports medicine for more than 40 years and has treated a multitude of international elite athletes. He has been the President of the Fédération Internationale de l'Automobile (FIA) Medical Commission since 2008 and the FIA Institute since 2011 after serving the sport for many years before.

When you started out, what were the major challenges that you faced in putting athletes’ health on the agenda of the world’s governing body in your sport?

In motor sport, the absolute priority is safety. Safety not only for the driver, but also for the marshals, officials, spectators etc. The specificity of motor sport is that even the smallest car accident can impact not only the driver of the car and other competitors, but also other people like spectators. This notion of safety first is the same for all disciplines with varying degrees of risk from one to the other (rally, circuits, hill climb, etc.). The safety action plan must therefore take into account a lot of parameters before, during and after a potential accident.

What were the major achievements for athletes’ health in your sport over the last decades?

I would say the major achievement is the very low risk of fatalities in circuit races today, when compared to the early 1990s and before, but this level is more difficult to achieve for road racing. This major improvement is due to very strict processes in terms of organisation for the entire medical cover of these sport events. It is essential that this safety level is the same in all countries where races take place (in particular for Formula 1).

In your opinion, what has been key for you to be able to win the executive/decision maker’s support for your initiatives?

There has never been an obstacle to these initiatives within the FIA. Quite to the contrary actually, it was always the will of the FIA President and the World Motor Sport Council to put safety first, before any other consideration like performance, spectacle or economics.

Are you satisfied with the achievements to date and what do you believe the future focus should be?

There is always room for improvement in the field of safety, but also regarding information on anti-doping. We see many positive test results, but they are mainly due to ignorance of the rules rather than to the intention to cheat. But the biggest challenge is the transfer of knowledge and safety levels from the pinnacle events to the grassroots events (local and regional). In these competitions, the risks are even greater, for various reasons: less experienced drivers, less well-prepared cars, lower level of organisation because of financial constraints, etc. This transfer of knowledge must also happen from motor sport to daily road traffic, both regarding safety and environmental sustainability.

What is your impression of the progress in other sports?

It is difficult to answer this question, but I think that in all Federations, respect for the human being and protection of the individual have become more and more important. This is not always easy given the high sporting and financial stakes. I think that the challenge for the 21st century will be for International Federations to spread the message that the rational and reasonable practice of sport is the best prevention against many diseases caused mainly by sedentariness. It is precisely the role of Medical Commissions to raise awareness of this within the Federations, who are often more preoccupied by the number of licensed athletes and medals.

What would you advise young colleagues aspiring to develop sports medicine in International Federations?

When you are on the Medical Commission of an International Federation, it is very important to keep your feet firmly on the ground and stay in contact with the grassroots. Also, you must go beyond your own national sporting culture and get to know the problems and solutions in other countries including developing ones, which may not have the same approach to sport. And you must never forget that you are the guarantor of the physical and moral integrity of the athlete.

Dr Michel D’Hooghe has combined sports medicine with political functions throughout his career. Starting out as team physician, he was a club and then National Association President, going on to become the Chairman of the UEFA and FIFA Medical Committees and member of these bodies’ Executive Committees for more than 25 years.

When you started out, what were the major challenges that you faced in putting athletes’ health on the agenda of the world’s governing body in your sport?

The first thing to do at the Executive Committee level of FIFA was to create a genuine interest and concern for the medical aspects of football: general health principles, physical condition, prevention, rehabilitation and the fight against doping.

What were the major achievements for athletes’ health in your sport over the last decades?

• The improvement of the medical care in different fields (musculoskeletal, cardiologic, neurologic).

• The increase in attention on all aspects of prevention.

• The increase in attention on the fight against doping.

In your opinion, what has been key for you to be able to win the executive/decision maker’s support for your initiatives?

Undoubtedly, the fact that I am not only a sports medicine doctor, but also a sports-political leader. This gave me credibility and created a great level of trust between my colleagues and I. I do speak both 'languages' and understand the thought processes in both areas, and that allowed me to convince my colleagues on the Executive Committee of the importance of my medical proposals.

Are you satisfied with the achievements to date and what do you believe the future focus should be?

When you look at the long way we have come over the last 25 years, thanks to the FIFA Medical Committee and the scientific support of FIFA’s Medical Assessment and Research Centre F-MARC, we have some reasons to be satisfied. Players’ health is central to FIFA’s strategy today. However, a lot remains to be done in the future and modern technologies will play an important role.

What is your impression of the progress in other sports?

Also in other sports, great improvements have been made in recent years, concerning both the general medical care and specific care within each sports discipline. There is also a collegial exchange of findings and initiatives as well as much closer collaboration among the medical professionals of the different federations.

What would you advise young colleagues aspiring to develop sports medicine in International Federations?

Young colleagues should be aware that if they want to participate in and lead the way forward in sports medicine in International Federations, two aspects are of utmost importance:

• The scientific base: accurate knowledge of the different medical aspects of the concerned sports discipline.
• The ability to effectively communicate the 'medical' message to the leadership of the federation, so that they support and implement adaptations in the regulations and the organisation of the sport to maximally protect the health and wellbeing of their athletes.

And always remain humble and consider yourself a servant – to the athletes, to the organization and to the sport.