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

0:00Good 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 Plus subscribers. Now, if you haven't heard of NPR Plus, 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. Up First will 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.

0:47And sign up for NPR Plus at plus.npr.org today. That's plus.npr.org. Thank 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. He's asked the Supreme Court to delay implementation of the law banning the app until after his inauguration. I'm Scott Simon. I'm Daniel Estrin. And this is Up First from NPR News. The law forces TikTok to be shut down or sold next month. We'll have more on that story. Also, North Korean soldiers fighting with Russia against Ukraine. U.S. officials say they're dying in high numbers. These North Korean soldiers appear to be highly indoctrinated, pushing attacks even when it is clear that those attacks are futile.

1:42And mixed feelings after the FDA declares the end of an obesity drug shortage. Stay with us. We have the news you need to start your weekend.

2:20Thank you. beat your copay. Save time and money on prescriptions at goodrx.com slash upfirst. This message comes from Dell Technologies. The new Dell PC with Intel Core Ultra helps you fast forward through busy work, leaving more time for you time. Get a new Dell PC at dell.com slash ai dash pc. This message comes from NPR sponsor Odoo. Some describe Odoo like a magic beanstalk because it scales with you and is magically affordable. Odoo, exactly what a business needs. Sign up at odoo.com. That's O-D-O-O dot com. A law forcing TikTok sale or closure is set to go into effect January 19th, just one day before President-elect Trump's inauguration.

3:11But Trump has asked the Supreme Court to delay its implementation so he can resolve the issue. And Piers Bobby Allen joins us. Bobby, Thanks for being with us. Thanks, Scott. What is Donald Trump asking the Supreme Court to do? 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. How might this affect the Supreme Court's review of TikTok? You know, that's really hard to say.

3:45In 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.

4:20Experts also noted to me that Trump is citing no legal authority for this request. Bobby, this case has been gathering steam for a number of years. How did it come to this? 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.

4:54But looming over the legal saga has been President-elect Donald Trump. Remember, he started the TikTok ban movement during his first term. And now he is the very one promising to save the app. And any indication of why he changed his mind? 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 polls. 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.

5:27They include Jeff Yoss, whose investment firm Susquehanna Investment Group has a large stake in ByteDance. Yoss 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 Sun has promised Trump that SoftBank will invest$100 billion in the U.S. Bobby, how might this affect the millions of Americans who use the app each and every day? 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 back and says the ban law is completely legal.

6:08It 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 is purchased away from its Chinese parent company, thus satisfying the law. So we don't know for sure, but for all the TikTokers out there who use the app every day, I think it's fair to say it's unlikely it will be disappearing anytime soon. And Paris technology correspondent, Bobby Allen, thanks so much. Thanks much, Scott.

6:45We're learning more about the roughly 10 ,000 North Korean soldiers fighting alongside the Russians in Eastern Europe. Western officials say the soldiers are being assigned to missions that have little chance of succeeding. And Piers Brian Mann has been following developments in Kiev. Brian, thanks for being with us. Good morning, Scott. Why North Korean soldiers alongside Russians in the first place? 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 have been talking to point out you need a lot more soldiers when you're on the off fence as Russia is now.

7:21They'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. 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.

7:55Now, what's interesting is Barros 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. And what do these assaults by North Korean troops look like? Well, the description is pretty horrific. White House National Security Communications Advisor 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.

8:27These 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. 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. Brian, what can you tell us about those reports of North Korean soldiers taking their own lives?

9:05Yeah, this is pretty grim. Ukraine's president Volodymyr Zelensky also spoke about this yesterday.

9:16The North Koreans do everything, so it's impossible for us to capture them alive, Zelensky said. Their own soldiers kill 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. You did say Russia is gaining ground. What does it look like for Ukraine? 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.

9:51But 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 U.S. 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. Brian Mann in Kyiv, thanks so much. Thank you.

10:35Weight loss drugs such as Ozempic have been in short supply in recent years because of their popularity. But the FDA has declared the official shortage of one of those medications, ZepBound, to be over. And that has caused some mixed feelings, especially among patients prescribed the drug. And Pierce Pharmaceuticals correspondent Sidney Lupkin joins us. Sidney, thanks so much for being with us. Yeah. Hi, Scott. But I gather the ending of a drug shortage is eliciting mixed feelings. 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.

11:11Here's what's happening. Terzepatide is the active ingredient in Eli Lilly's ZepBound for Obesity and Manjaro for Diabetes. Specialized pharmacies called compounding pharmacies have been legally allowed to make what are essentially copies of terzepatide 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. That's a big difference. 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.

11:49The compounders said there was no way the shortage could be over because many patients still couldn't fill their name brand 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 trisepatide shortage resolved. Why does the FDA think the shortage is over this time? The agency says it took a look at many factors, including the drug manufacturer's inventory data, projected demand. and it says it also spoke to patients, healthcare providers, and compounding pharmacies.

12:24Bottom line, the agency said it thinks Eli 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. But Sydney, aren't a lot of people taking compounded obesity drugs already? 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 weight loss.

13:00Medicare, 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. What are those patients going to do? Some are stockpiling the compounded drugs while they can. I checked in with Mary Strewski, an Arizona woman who told me a few weeks ago about how she lost 50 pounds so far on compounded terzepatide.

13:35She says she and her nurse practitioner settled on a plan to buy enough terzepatide 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. I'm a changed person, and it's primarily because it has changed me fundamentally and the way I go about life every day. 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. Could insurance coverage for the name brand ZetBound get better now that the compounded versions are off the table? You know, it could because the FDA just approved ZetBound as the first drug treatment for moderate to severe obstructive sleep apnea in patients who have obesity.

14:23Obstructive 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 ZEP-bound 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. NPR Pharmaceuticals correspondent Sidney Lupkin, thanks so much. You bet.

14:55And that's Up First for Saturday, December 28, 2024. I'm Scott Sein. And I'm Daniel Estrin. Our producer is Michael Radcliffe. He had assistance from Gabe O 'Connor and Ryan Bank. Our director is Andrew Craig. Our editors are Cara Platoni, Shannon Rhodes, Miguel Macias, Nick Spicer, Fernando Roman, and Matthew Sherman. Andy Huther is our technical director with engineering support from Zach Coleman, David Greenberg, and Arthur Halliday-Lorett. Evie Stone is our senior supervising editor. Sarah Lucy Oliver is our executive producer. And Julia Redpath was with us this week as well. Luis Clemens is our deputy managing editor.

15:33Tomorrow on the Sunday Story from Up First, we go for a walk in the park. Specifically, Flushing Meadows Park in Queens, New York. It's near one of the most diverse inhabited areas in the world. 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? I was just thinking I haven't seen one in a while. Maybe with that little antenna you put up. You could just bring your smartphone. That might be easier. Go to stations.npr.org to find your local NPR station.

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