Trump On TikTok Ban, N. Korean Soldiers in Ukraine, Obesity Drug Shortage Ends

Summary

Up First from NPR – December 28, 2024

NPR's Up First delivered a comprehensive and engaging rundown of the day's most pressing news stories in its December 28th episode, hosted by Scott Simon and Daniel Estrin. The episode delved into three major topics: President-elect Donald Trump's stance on the TikTok ban, the involvement of North Korean soldiers in the Ukraine conflict, and the resolution of an obesity drug shortage. Below is a detailed summary capturing the key discussions, insights, and conclusions from each segment.

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1. President-Elect Trump Seeks Delay on TikTok Ban

Overview: The episode opened with a significant development in the ongoing TikTok saga. President-elect Donald Trump has formally requested the Supreme Court to postpone the enforcement of a new law that mandates the shutdown or sale of TikTok by January 19, 2025—just one day before his inauguration.

Key Points:

• Trump's Appeal to the Supreme Court: Trump has sought a delay in the TikTok ban's implementation, aiming to address the issue post-inauguration. “Trump is urging the court to pause the start date of a law that would shut down TikTok nationwide unless it is sold away from its China-based parent company” (03:35) explained Bobby Allen, NPR’s technology correspondent.

• Potential Implications: Bobby Allen highlighted the uncertainty surrounding the Supreme Court's response. The president-elect's move suggests a willingness to negotiate a sale of TikTok, positioning himself as a potential dealmaker. Allen noted, “Trump seems to be acting as if he is president before he is even sworn in” (04:37), pointing out the unprecedented nature of his request.

• Historical Context and Influences: The TikTok ban traces back to Trump's first term, driven by concerns over the app's ties to China. Allen discussed possible influences behind Trump's reversal, including significant investments by influential donors like Jeff Yass of Susquehanna Investment Group and Masayoshi Sun of SoftBank, who stand to benefit from a sale of TikTok (05:19).

• Impact on TikTok Users: Despite the legal battles, Allen emphasized that the app's shutdown remains unlikely in the near term. “It's unlikely [TikTok will be disappearing] anytime soon” (06:09), providing reassurance to millions of users dependent on the platform.

Notable Quote: Bobby Allen remarked, “Trump seems to be acting as if he is president before he is even sworn in,” underscoring the controversial nature of his intervention (04:37).

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2. North Korean Soldiers in the Ukraine Conflict

Overview: The second major story covered the alarming presence of approximately 10,000 North Korean soldiers fighting alongside Russian forces in Eastern Europe. The report shed light on the high casualty rates and the brutal nature of their missions.

Key Points:

• Deployment and Casualties: Brian Mann, an NPR correspondent in Kyiv, revealed that North Korean soldiers are being deployed in missions with minimal chances of success, leading to significant casualties. “Russia is now burning through roughly 30,000 troops every month that's killed and wounded,” explained John Kirby, White House National Security Communications Adviser (07:21).

• Nature of Combat Missions: The North Korean troops are reportedly engaged in what can only be described as suicide missions, attacking heavily fortified Ukrainian positions with inadequate support. Mann detailed, “North Koreans are sent on foot over open ground without necessary support or equipment” (08:21).

• Psychological Impact and Losses: Reports indicate that many North Korean soldiers are taking their own lives to avoid capture, driven by fears of severe repercussions at home. Ukrainian President Volodymyr Zelensky stated, “The North Koreans do everything, so it's impossible for us to capture them alive” (09:17).

• Broader Implications for Ukraine: While Russia gains ground, the relentless loss of manpower is taking a toll. Mann highlighted Ukraine's dire need for continued U.S. military support, expressing concerns that upcoming political changes in the U.S. could jeopardize promised aid (10:34).

Notable Quote: John Kirby described the missions as “basically suicide missions,” illustrating the extreme conditions faced by North Korean soldiers (08:21).

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3. Resolution of the Obesity Drug Shortage

Overview: The final segment addressed the FDA’s declaration that the shortage of the obesity medication Zepbound (tirzepatide) has ended. This development brought mixed reactions among patients and healthcare providers.

Key Points:

• End of the Shortage: Sidney Lupkin, NPR’s pharmaceuticals correspondent, explained that the FDA’s decision is based on increased manufacturing capacity by Eli Lilly, the drug's manufacturer. “The agency thinks El Lilly can make enough,” Lupkin stated (12:24).

• Impact on Compounding Pharmacies: With the shortage declared over, compounding pharmacies that had been dispensing cheaper, unofficial versions of tirzepatide must cease production by early next year. This poses a significant financial burden for patients who relied on these affordable alternatives (12:56).

• Patient Reactions and Challenges: Many patients now face higher costs for their prescriptions. Lupkin shared stories like that of Mary Struski from Arizona, who plans to stockpile compounded drugs but remains uncertain about future access and affordability (13:00).

• Potential for Improved Insurance Coverage: The FDA’s approval of Zepbound for treating obstructive sleep apnea in patients with obesity may enhance insurance coverage options, potentially alleviating some financial pressures. “It could open the door for Zepbound coverage by Medicare and Medicaid” (14:25).

Notable Quote: Mary Struski expressed her predicament, saying, “I need to find a way to keep taking the medicine,” highlighting the personal struggles faced by patients due to the shortage (13:35).

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Conclusion

The December 28th episode of Up First provided listeners with in-depth analyses of critical issues affecting national security, international conflicts, and public health. From the unfolding legal battles surrounding TikTok and its implications for international relations, to the grim realities of North Korean involvement in Ukraine, and the nuanced challenges arising from pharmaceutical shortages, NPR delivered a well-rounded overview of the day’s top stories. Notable insights and expert opinions enriched the discussions, offering listeners a comprehensive understanding of each topic’s broader impact.

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Credits:

• Hosts: Scott Simon, Daniel Estrin
• Contributors: Bobby Allen (Technology Correspondent), Brian Mann (Kyiv Correspondent), Sidney Lupkin (Pharmaceuticals Correspondent)
• Production: Michael Radcliffe (Producer), Andrew Craig (Director), and the Up First team.

For more stories and updates, subscribe to Up First and support your local NPR station at donate.npr.org.

Transcript

[Scott Simon]

Good morning, everyone. Scott Simon here, and we hope you've had a great holiday week. Before we begin Up FIRST today, a special thank you to our NPR subscribers. Now, if you haven't heard of npr, it's a new way to support NPR through a simple recurring donation that unlocks sponsor free listening to every episode of up first. Plus, special perks for more than 25 NPR podcasts. Now, don't worry, I up first, we'll continue to be freely available to all because NPR is public media. That's the core of what we are. But we also look to you, the public, to help fund the service. We need a lot of people and equipment to get this podcast out to you each morning. And of course, that costs money. So please do your part for public media and sign up for [e-mail] today. That's plus.npr.org thank you. And now on with the show. President elect Donald Trump wants a chance to weigh in on the TikTok saga once he assumes office.

[Daniel Estrin]

He's asked the Supreme Court to delay implementation of the law banning the app until after his inauguration.

[Scott Simon]

I'm Scott Simon.

[Daniel Estrin]

I'm Daniel Estrin. And this is up first from NPR News. The law forces TikTok to be shut down or sold next month.

[Scott Simon]

We'll have more on that story. Also, North Korean soldiers fighting with Russia against Ukraine.

[Daniel Estrin]

U.S. officials say they're dying in high numbers.

[Bobby Allen]

These North Korean soldiers appear to be highly indoctrinated, pushing attacks even when it is clear that those attacks are futile.

[Scott Simon]

And mixed feelings after the FDA declares the end of an obesity drug shortage.

[Daniel Estrin]

Stay with us. We have the news you need to start your weekend.

[Sidney Lupkin]

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[Scott Simon]

A law forcing TikTok sale or closure is set to go into effect January 19, just one day before President elect Trump's inauguration.

[Daniel Estrin]

But Trump has asked the Supreme Court to delay its implementation so he can resolve the issue.

[Scott Simon]

NPR's Bobby Allen joins us. Bobby, thanks for being with us.

[Bobby Allen]

Thanks, Scott.

[Scott Simon]

What is Donald Trump asking the Supreme Court to do?

[Bobby Allen]

Yeah, as you mentioned, Trump is urging the court to pause the start date of a law that would shut down TikTok nationwide unless it is sold away from its China based parent company. And in the filing, Trump says he possesses the consummate deal making expertise to broker a sale of the app.

[Scott Simon]

How might this affect the supreme court's review of TikTok?

[Bobby Allen]

You know, that's really hard to say. In two weeks, lawyers for TikTok and the Department of Justice will be arguing in front of the Supreme Court over whether banning TikTok violates the Constitution or not. The date had been set earlier this month. Now, Trump's new brief does not take a position on the constitutionality of the TikTok ban, but does essentially say, well, Supreme Court, if you want to hold off on making a ruling, Trump will step in, strike a deal that might make the high court's intervention unnecessary completely. And I talked to legal scholars about this request and they said Trump seems to be acting as if he is president before he is even sworn in. Experts also noted to me that Trump is citing no legal authority for this request.

[Scott Simon]

Bobby, this case has been, has been gathering steam for a number of years. How did it come to this?

[Bobby Allen]

Yeah, it really has. You know, since TikTok became a global sensation during the pandemic, Washington has been very worried about the company's ties to China. And those fears really escalated in April when Congress passed a law banning TikTok unless it sheds its Beijing parent company, ByteDance. And TikTok has been fighting this law. It lost in a lower court and appealed to the Supreme Court, which agreed to hear the case on this lightning fast schedule. But looming over the legal saga has been President Elect Donald Trump. Remember, he started the TikTok ban movement during his first term and now, now he is the very one promising to save the app.

[Scott Simon]

And any indication of why he changed his mind?

[Bobby Allen]

Yeah, you know, Trump had an active TikTok account during his presidential campaign, and he has credited the app with helping drive young people to the poll. So that's what he's saying publicly about why he now supports the app. But TikTok observers have also pointed to influential donors who are in touch with Trump's orbit and who are big investors in ByteDance. They include Jeff Yass, whose investment firm, Susquehanna Investment Group, has a large stake in ByteDance. Yass has never donated directly to the Trump campaign, but he was a major donor to conservative super PACs this past election. And then there's Masayoshi Sun, CEO of SoftBank, which also has a significant investment in TikTok's owner and son, has promised Trump that SoftBank will invest $100 billion in the U.S. bobby, how might this.

[Scott Simon]

Affect the millions of Americans who use the app each and every day?

[Bobby Allen]

Yeah, you know, at this point, Scott, it's really hard to imagine any situation where TikTok is shut down. Even if the Supreme Court comes, says the ban law is completely legal, it will then be up to the incoming Trump administration to enforce it. And Trump can instruct his Justice Department to just take a hands off approach and then try to work out a deal where TikTok has purchased away from its Chinese parent company, thus satisfying the law. So we don't know for sure, but for all the tick tockers out there who use the app every day, I think it's fair to say it's unlikely it will be disappearing anytime soon.

[Scott Simon]

NPR's technology correspondent Bobby Allen. Thanks so much.

[Bobby Allen]

Thanks much, Scott.

[Daniel Estrin]

We're learning more about the roughly 10,000 North Korean soldiers fighting alongside the Russians in Eastern Europe.

[Scott Simon]

Western officials say the soldiers are being assigned to missions that have little chance of succeeding and appears Brian Mann has been following developments in Kyiv. Brian, thanks for being with us.

[Brian Mann]

Good morning, Scott.

[Scott Simon]

Why North Korean soldiers alongside Russians in the first place?

[Brian Mann]

Yeah, it seems surprising on the face of it, doesn't it? Russian soldiers already outnumber Ukraine's army, which is much smaller. But military analysts I've been talking to point out you need a lot more soldiers when you're on the offense as Russia is now. They're trying to gain ground. I spoke about this with George Barros at the Institute for the Study of War. They track fighting in eastern Ukraine. He says, Scott, Russia is now burning through roughly 30,000 troops every month that's killed and wounded. So Moscow needs reinforcements.

[John Kirby]

The Russians are struggling to offset that 30,000 casualties per month figure. They basically have a system that's allowed them to be able to withstand and sustain that for the last two and a half years, but it's not working anymore. The North Koreans provided 10 days worth of casualties with that initial 10k investment.

[Brian Mann]

Now, what's interesting is Baros believes that as many as 3,000 of those North Korean soldiers have already been killed or wounded. I should say that's a high estimate. U.S. officials put the number of North Korean casualties around 1,000.

[Scott Simon]

And what do these assaults by North Korean troops look like?

[Brian Mann]

Well, the description's pretty horrific. White House National Security Communications Adviser John Kirby spoke about this yesterday, describing what are basically suicide missions. North Koreans are sent on foot over open ground without necessary support or equipment to attack heavily fortified Ukrainian positions.

[Bobby Allen]

These North Korean soldiers appear to be highly indoctrinated, pushing attacks even when it is clear that those attacks are futile. We also have reports of North Korean soldiers taking their own lives.

[Brian Mann]

Now, Kirby does acknowledge these attacks are putting a strain on the Ukrainians, who also face a very serious manpower shortage. And Russia has been gaining ground in Kursk and other areas along the Eastern Front, but that progress is slow. And Russia, and now North Korea, they're paying a huge price in manpower.

[Scott Simon]

Brian, what can you tell us about those reports of North Korean soldiers taking their own lives?

[Brian Mann]

Yeah, this is pretty grim. Ukraine's President, Volodymyr Zelensky also spoke about this yesterday. The North Koreans do everything, so it's impossible for us to capture them alive. Zelensky said their own soldiers killed them off. Npr, I should say, hasn't been able to independently verify this, but the theory shared by Ukrainian officials and the White House is North Korean soldiers fear for their families. They think they'll face reprisal and punishment back home if they're taken prisoner, so they choose to take their own lives.

[Scott Simon]

You did say Russia is gaining ground. What does it look like for Ukraine?

[Brian Mann]

Yeah, it's been a really grinding, brutal winter for Ukraine, Scott. Military analysts say Russia's offensive is poorly planned and executed, as we've been discussing. But the sheer weight of soldiers and artillery are pushing Ukraine back. In a national address this week, Zelensky talked about a desperate need to stabilize Ukraine's defenses. One big question here in Kyiv is whether the US will actually deliver most of the $61 billion in additional military and economic aid for Ukraine that was allocated by Congress last spring. They're hoping it'll come before President Biden leaves office. People here fear that once President elect Donald Trump is sworn in next month, much of that aid could be frozen.

[Scott Simon]

Brian Mann in Keev, thanks so much.

[Brian Mann]

Thank you.

[Daniel Estrin]

Weight loss drugs such as Ozempic have been in short supply in recent years because of their popularity but the FDA.

[Scott Simon]

Has declared the official shortage of one of those medications, Zepbound, to be over.

[Daniel Estrin]

And that has caused some mixed feelings, especially among patients prescribed the drug.

[Scott Simon]

And Paris Pharmaceuticals correspondent Sidney Lupkin joins us. Sidney, thanks so much for being with us.

[Sidney Lupkin]

Yeah, hi, Scott.

[Scott Simon]

But I gather the ending of a drug shortage is eliciting mixed feelings.

[Sidney Lupkin]

Yeah, and, you know, in most circumstances, it would be celebrated all around, but in this case, many people will end up spending more to manage their obesity. Here's what's happening. Tirzepatide is the active ingredient in Eli Lilly's Zepbound for obesity and Mounjaro for diabetes. Specialized pharmacies called compounding pharmacies have been legally allowed to make what are essentially copies of Tirzepatide because the brand name drugs were in shortage and the compounded versions of the medicines were a lot cheaper. A few hundred dollars a month for patients compared with $1,000 or more for the brand name drugs.

[Scott Simon]

That's a big difference.

[Sidney Lupkin]

Yeah.

So the stakes are high. In October, FDA first said the shortage was over, but a trade group for the largest compounding pharmacies sued the fda, challenging that determination. The compounders said there was no way the shortage could be over because many patients still couldn't fill their name brand prescript prescriptions. And they alleged that the FDA hadn't determined how many people would need to make the switch from the compounded to the name brand drugs either. So the FDA took another look and for a second time declared the tirzepatide shortage resolved.

[Scott Simon]

Why does the FDA think the shortage is over this time?

[Sidney Lupkin]

The agency says it took a look at many factors, including the drug manufacturer's inventory data, projected demand. It says it also spoke to patients, healthcare providers, and compounding pharmacies. Bottom line. The agency said it thinks El Lilly can make enough. Lilly said in a statement that the FDA decision reflects the company's hard work to expand its manufacturing capacity and meet patient needs. So compounding pharmacies will need to stop making and selling the compounded versions in February or March, depending on their size.

[Scott Simon]

But, Sydney, aren't a lot of people taking compounded obesity drugs already?

[Sidney Lupkin]

Yes, though the exact number is hard to pin down. I've heard from lots of patients who consider them a lifeline, and that's because many health insurers won't cover the drugs for Medicare, for instance, is banned from covering drugs for weight loss because of an old law written at a time when having obesity was considered more of a personal failure than a health condition. That means people without coverage will have to pay the full sticker price for the name brand drugs. And that's unaffordable for a lot of people who've turned to the cheaper compounded versions of the drugs.

[Scott Simon]

What are those patients gonna do?

[Sidney Lupkin]

Some are stockpiling the compounded drugs, you know, while they can. I checked in with Mary Struski, an Arizona woman who told me a few weeks about how she lost £50 so far on compounded Tirzepatide. She says she and her nurse practitioner settled on a plan to buy enough tirzepatide to get her through until about April, and after that she isn't sure. But she says she needs to find a way to keep taking the medicine.

[Bobby Allen]

I'm a changed person, and it's primarily because it has changed me fundamentally and the way I go about life every day.

[Sidney Lupkin]

Her health is better, and she says she's free of the anxiety that came with eating. She's thinking about what she wants to accomplish in 2025.

[Scott Simon]

Could insurance coverage for the name brand Zepbound get better now that the compounded versions are off the table?

[Sidney Lupkin]

You know, it could because the FDA just approved Zepbound as the first drug treatment for moderate to severe obstructive sleep apnea in patients who have obesity. Obstructive sleep apnea is a condition in which someone temporarily pauses breathing in their sleep because their upper airway collapses. It is more common among people who have obesity. The new approval could open the door for Zepbound coverage by Medicare and Medicaid because it's not just a weight loss drug anymore. So while that's not going to solve everyone's insurance problems here, it could help a lot of people.

[Scott Simon]

NPR pharmaceuticals correspondent Sidney Lupkin. Thanks so much.

[Bobby Allen]

You bet.

[Scott Simon]

And that's up first for Saturday, December 28th, 2024. I'm Scott Syme.

[Daniel Estrin]

And I'm Daniel Estrin.

[Scott Simon]

Our producer is Michael Radcliffe. He had assistants from Gabe O'Connor and Ryan Behnk. Our director is Andrew Craig.

[Daniel Estrin]

Our editors are Cara Platoni, Shannon Rhodes, Miguel Macias, Nick Spicer, Fernando Roman, and Matthew Sherman.

[Scott Simon]

Andy Huether is our technical director with engineering support Brum, Zach Coleman, David Greenberg and Arthur Halliday.

[Daniel Estrin]

Loretta Evie Stone is our senior supervising editor. Sarah Lucy Oliver is our executive producer. And Julia Redpath was with us this week as well.

[Scott Simon]

Luis Clemens is our deputy managing editor.

[Daniel Estrin]

Tomorrow on THE Sunday STORY from Up first, we go for a walk in.

[Scott Simon]

The park, specifically Flushing Meadows park in Queens, New York. It's near one of the most diverse inhabited areas in the world.

[Daniel Estrin]

And if you really do go to the park this weekend, why not bring along a portable radio and listen to Weekend Edition? Do those things still exist, portable radios?

[Scott Simon]

Scott I was just thinking I haven't seen one in a while.

[Daniel Estrin]

Maybe with that little antenna you put up.

[Scott Simon]

Yeah.

[Daniel Estrin]

You could just, you know, bring your smartphone. That might be easier. Go to stations.NPR.org to find your local NPR station.

[Sidney Lupkin]

This message comes from Warby Parker. What makes a great pair of glasses at Warby Parker? It's all the invisible extras without the extra cost, like free adjustments for life. Find your [e-mail] or visit one of their hundreds of stores around the country. This message comes from NPR sponsor Mint Mobile. From the gas pump to the grocery store, inflation is everywhere. So Mint Mobile is offering premium wireless starting at just $15 a month. To get your new phone plan for just $15, go to mintmobile.com Switch this message comes from NPR sponsor Mint Mobile. From the gas pump to the grocery store, inflation is everywhere. So Mint Mobile is offering premium wireless starting at just $15 a month. To get your new phone plan for just $15, go to mintmobile.com switch.