Trimetazidine, doping sparks fairness concerns ahead of Paris Olympics

The World Anti-Doping Agency is under scrutiny for its decision to clear 23 Chinese swimmers to compete at the 2021 Tokyo Olympics after they tested positive for trimetazidine, a heart medication WADA banned in 2014

With the Paris Olympics less than a month away, concerns remain about the regulation of anti-doping rules at the world's largest multi-sport event.

The World Anti-Doping Agency is under scrutiny for its decision to clear 23 Chinese swimmers to compete at the 2021 Tokyo Olympics after they tested positive for trimetazidine (TMZ), a heart medication WADA banned in 2014.

Normally prescribed to treat chest pain by increasing blood flow to the heart, TMZ can help athletes "improve physical efficiency, especially in the case of endurance sports," according to a 2014 study. The drug is a metabolic modulator that allows higher heart rates to be maintained for a longer period of time, helping with training, endurance and recovery. It is banned both in competition and out of competition.

The Chinese swimming team went on to win six medals at the Tokyo Olympics, including three gold. Chinese authorities said the swimmers, who had tested positive for TMZ seven months before the Games, had accidentally ingested the substance due to contaminated spice containers in the kitchen of the hotel they stayed at.

WADA accepted the explanation, including in its reasoning that the levels of TMZ found were very low and that the swimmers were all at the same hotel when the positive tests occurred.

Even if WADA had appealed the case to the Court of Arbitration for Sport, the Agency argued, it would not have kept the athletes from competing in Tokyo.

WADA has been criticized for not questioning the 2 1/2-month delay it took for Chinese authorities to report the positive tests, as well as the lack of publication of any science behind its decision.

American Olympic swimming champions Michael Phelps and Allison Schmitt testified before a House committee on June 25. They said anti-doping rules were being applied unequally, allowing countries like Russia and China to skirt such measures, much to the frustration of clean athletes.

Phelps said he was drug-tested 150 times in one year, while other Olympic delegations were tested only 30 to 40 times across all their athletes.

"There are still deeply rooted systemic problems that prove detrimental to the integrity of international sports and athletes' right to fair competition, time and time again,” Phelps said.

Schmitt was part of the 4x200 relay team that had placed second in Tokyo behind the Chinese team, which included several swimmers who were involved in the doping scandal.

"We followed every protocol and accepted our defeat with grace," Schmitt said. "With these revelations, many of us will be haunted by this podium finish that may have been impacted by doping."

This is not the first time TMZ has been used by Olympic athletes.

Weeks before the 2022 Beijing Winter Olympics, Russian figure skater Kamila Valieva tested positive for TMZ. The then-15-year-old said the medication belonged to her grandfather and had accidentally contaminated her food. She was stripped of her gold medal and suspended for four years.

The difference between Valieva's case and the Chinese swimmers', WADA said, was that Valieva's reasoning was "not compatible with the analytical results." China's contamination scenario was "plausible" and lacked a concrete scientific element that could challenge it, the Agency said.

Russian figure skater Valieva disqualified from 2022 Olympics for doping

Russian figure skater Kamila Valieva was disqualified from the 2022 Olympics on Monday by the Court for the Arbitration of Sport, nearly two years after a doping case led to controversy.

In 2018, Russian bobsledder Nadezhda Sergeeva was suspended for eight months after testing positive for TMZ, just weeks after she was seen wearing an "I Don't Do Doping" sweatshirt.

Four years prior, Chinese swimmer Sun Yang was also suspended for three months for TMZ use.

Eleven of the 23 swimmers who tested positive in 2021 will compete in Paris, China announced earlier this month. The team includes Zhang Yufei, who took home two gold medals for the 200-meter butterfly and women's 4x200 freestyle relay, as well as two silvers medals; 200 individual medley gold-medalist Wang Shun; and 200 breaststroke world-record holder Qin Haiyang.

“It’s hard going into Paris knowing that we’re going to be racing some of these athletes,” American swimmer and seven-time Olympic champion Katie Ledecky said in a television interview. “I think our faith in the system is at an all-time low.”