Cluster Bombs For Ukraine, OK For Alzheimer's Drug, Progressive Pressure On Biden

The FDA says a drug to treat Alzheimer's has its full approval.

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If they gain more power, it could mean fewer rights for you.

I'm Heath Druzin, and on the new season of Extremely American, I'll take you inside the movement.

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The pros and cons of artificial intimacy.

But they're also controversial, and many nations have pledged not to use them.

So we're joined by NPR national security correspondent Greg Myrie in Ukraine's capital of Kiev.

Greg, thanks so much for being here.

And while the cluster bomb is in the air, it breaks open and releases dozens or even hundreds of little bomblets.

And this can be very effective when used against troops spread out over a big area because there's not just one explosion.

All these little bomblets are intended to explode over a vast space the size of a city block or so.

However, some bomblets are duds.

They don't detonate.

They're small.

They remain on the ground.

They can become embedded just below the surface.

So years later, after a war is over, civilians can walk through these areas and step on the bomblets, causing them to explode and inflicting injury or death.

For this reason, human rights groups say they shouldn't be used, really for the same reason they opposed landmines.

Russia has used them extensively in Ukraine to a lesser degree, according to research by Human Rights Watch.

And more than 120 countries, including most NATO members, pledged not to use them under a 2008 convention.

But Russia, Ukraine, and the U.S. are not part of that agreement.

The U.S. has used them in the past.

I remember them as far back as the first U.S. war in Iraq in 1991.

It looked like a really bad golfer had left dozens of big divots all over the course.

And that instantly grabbed your attention because when you saw this, you knew some unexploded bomblets were lurking nearby.

And why now?

Ukraine is trying to break through Russian lines in the east and the south where the Russian troops are deeply entrenched.

And the cluster munitions could be a very valuable weapon because you can hit a larger patch of territory with just one of these weapons compared to a conventional artillery shell.

The U.S. has a large supply of them on the shelf, so it can presumably give them to Ukraine pretty quickly.

And U.S. officials have told NPR that the dud rate has come down substantially.

Mine clearing groups used to talk about rates of 20% or more.

The U.S. says it will only be sending those with a dud rate of around 2% or less.

Some critics, though, do question the Pentagon's claim that the rate is really this low.

Now, these figures have very little changed over the last week or two, and it's much slower and more limited than many expected.

And when you give it to people in the early stages of Alzheimer's, it appears to slow down the loss of memory and thinking by about 27%.

That all sounds pretty good, but this effect is really pretty modest.

And the question a lot of doctors have right now is whether this drug will really make a difference to most patients and their families.

So I actually asked Dr. Sanjeev Vaishnavi. He's a neurologist at University of Pennsylvania.

Here's what he said about Lekembe.

But it may slow down progression of the disease and may give people more meaningful or quality time with their families.

These are antibodies that are made in the lab and they're programmed to go after a specific target in the body.

This drug is designed to find and remove a substance in the brain called amyloid beta.

In people with Alzheimer's, amyloid beta tends to form these clumps and eventually these sticky plaques that build up between brain cells.

Scientists think that somewhere along the way in this process, something damages brain cells and leads to dementia.

They think Lekembe works by interfering with that process.

Would you just tell us what exactly that means and why does that matter?

It's a sort of a conditional approval that was based purely on its ability to remove amyloid from the brain.

That meant doctors could actually prescribe the drug, but Medicare generally wouldn't pay for it

because the drug had not shown that it had actually slowed down the disease.

And by the way, this drug is expensive. It costs about $26,500 a year.

So now this full approval means the FDA now believes the drug really does help patients.

And it also means that Medicare will pay.

That is critical because Medicare covers people 65 and older.

And in other words, we're talking about the vast majority of people with Alzheimer's.

This drug is only for people who are in the very early stages of Alzheimer's and have elevated levels of amyloid.

So even with that restriction, though, this drug could potentially reach a million people or more.

And unfortunately, it has side effects.

And that seems to be related to the process of removing amyloid, which can actually cause inflammation.

So in other words, the process that is helping the brain can also cause damage.

So when people first start taking this drug, they are required to get periodic brain scans to look for trouble.

Thank you.

So far, his record on delivering on these promises has been mixed.

And in the run up to 2024, some progressive voters and activists want Biden to do more and do it faster.

Good morning.

The Supreme Court blocked Biden's debt relief plan last week.

Obviously, a disappointment for people who are counting on that, even maybe budgeting for that.

But how are progressive voters responding to that?

And I'm particularly interested in if they blame Biden or the court for their disappointment about all this.

You heard the president say that he knows people are disappointed, but he rejected that he gave people false hope.

And he's trying to lay the blame on Republicans.

But what has also stood out to progressive groups that I spoke with is that Biden bounced back with another plan immediately.

It'll take longer, but they were happy that Biden didn't just throw his hands up on this issue.

And they think he should apply that same strategy to some other issues as well.

Here's Joseph Givargis.

He's with a group called Our Revolution.

It's a political organization which was started by supporters of Senator Bernie Sanders.

The president's made a down payment, but he's got to fight like hell in the remaining period of time to show voters that he's doing everything in his power to deliver on the pocketbook issues that matter to him.

Debra, does that suggest that it's going to cut into support for the president in 2024?

I talked to Adam Green, who's the co-chair of the Progressive Change Campaign Committee.

It's a group that backs lawmakers like Senator Elizabeth Warren.

But he says Biden is doing something effective, and that's the strategy of drawing contrasts with his own agenda and the agenda of right-wing Republicans.

He really needs to make clear what the battle lines are so that regular people who live busy lives say, oh, I actually care about that.

It's worth my time to vote.

And that's a message that Biden will be taking to the trail in 2024.

Where do progressive groups think Biden can still take more aggressive action?

But climate action is a big issue where a lot of voters feel like Biden has backed out on what he promised in 2020.

For example, the president campaigned on promises to end new drilling on federal lands in order to rein in emissions.

But he approved a new venture in Alaska called the Willow Project earlier this year.

Millions of people petitioned against it.

Climate activists see it as the total about face and a disappointment for people who voted for Biden based on his climate agenda.

But I'll add here that Biden has already picked up a number of endorsements from environmental and conservation groups.

And he's campaigning hard on his record on investing in clean energy projects.

I'm Michelle Martin.

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