Anwar Ali hopes latest medical research helps him return to action

Anwar Ali's career has been in limbo since he was diagnosed with a rare heart condition last year. Maja Hitij - FIFA/FIFA via Getty Images

Former U-17 World Cup star Anwar Ali has submitted expert medical opinion to the AIFF medical committee that suggests he should be allowed to resume his professional career with certain conditions in place. Ali's career has been in limbo since he was diagnosed with a rare heart condition called apical hypercardio myopathy (HCM) last year.

Professor Sanjay Sharma, a fellow of the European Society of Cardiology (ESC), testified to Ali's suitability to return to competition to the AIFF medical committee, and also produced a medical report to that effect. While earlier recommendations of the ESC had advised athletes with HCM to abstain from competitive sports, the latest guidelines published by the same body on August 29, 2020, suggested taking a more 'liberal approach'.

Sharma is one of the leading authorities on the subject of sports cardiology in Europe, serves as the Cardiology Advisor to the English Football Association and oversees the cardiovascular screening programme for Youth Academy players of the 92 clubs affiliated with the FA.

"The general recommendations by the 2010 European Society of Cardiology were to advise athletes with HCM to abstain from competitive sports that have a moderate or high dynamic and static component such as soccer. It became recognised, however, that these guidelines were created by a consensus panel and were based on circumstantial rather than scientific evidence," Sharma, a professor of Sports Cardiology at St. George's University of London, wrote in his report, submitted to the AIFF on Sunday.

"The guidelines were homogenous, whereas HCM is an extremely heterogeneous condition; therefore, it was inevitable that many athletes who would have never experienced potentially fatal exercise-associated arrhythmias would also be included...Therefore, more recent recommendations... suggest that it may be reasonable for some affected individuals with morphologically mild disease to participate in high-intensity exercise provided they were asymptomatic, had a low ESC risk profile," the report said. Sharma added that Ali did not have any obvious risk factor such as a family history of sudden death from HCM, exercise induced arrhythmias etc.

According to medical tests conducted in the first week of October, Professor Sharma suggested Anwar's case was one of low risk. "..it may be considered reasonable for him to participate in competitive football. I do not usually take it upon myself to disqualify athletes from competitive sport because I believe that this is an infringement of rights, unless they exhibit obvious high-risk features. It is my feeling that the decision to play should be ultimately left up to the player providing he understands the risks and following this it is up to the club to decide whether they chose to play him," he said.

However, Sharma added that there were risk factors and precautions that Ali would have to consider. Due to his age, he advised that Ali be assessed for HCM once again in six months. Sharma added that it was essential that any team Ali plays for have medical personnel trained in cardio-pulmonary resuscitation and the use of a defibrillator, which needed to be on standby each time Ali was training or competing. The report also suggested that Ali should not compete in hot environments over 30°C unless he was already acclimatised to those conditions.

According to Ranjit Bajaj, who runs the Minerva Academy, where Ali received his early training, and who is championing his campaign to resume his career, Sharma's report, despite its caveats, was a shot in the arm for the 20-year-old's prospects. "A lot of the medical opinion that is being considered in Ali's case is coming from cardiologists who have little expertise when in comes to dealing with sportspersons. We wanted to provide a definitive authority whose voice carried weight in the matter," Bajaj says.

The meeting had only been set up after the Delhi High Court had asked the AIFF to convene a meeting of its medical committee and give Ali a fair hearing. Ali had taken the federation to court last month to pursue his right to resume his career after being denied permission by the AIFF to train with his club.

According to Bajaj, in response to Professor Sharma's report and testimony, the medical committee suggested they would need time to study the report. "They have told us they would get back to us after considering the report," he said. The AIFF medical committee is due to make a recommendation over the next week while Ali's case against the AIFF will have its next hearing on October 20.