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U.S. allies have a reminder this week of how much their fate is tied to the U.S. presidential election.


They're in Washington for a NATO summit. And President Biden spoke there about how the North Atlantic Alliance came to the defense of the U.S. after the 9/11 attacks and is now working to support Ukraine.


PRESIDENT JOE BIDEN: Again and again, we stood behind our shared vision of a peaceful and prosperous trans-Atlantic community. Here at this summit, we gather to proclaim NATO is ready and able to secure that vision today and well into the future.


PFEIFFER: But Biden himself is under pressure. He's trying to reassure Democratic lawmakers, donors, and the allies in the room that he can win this fall's election and serve four more years. When Trump was president, he had difficult relations with European leaders. Trump has also sometimes praised Russia's leader and said he will end the Ukraine war, although he hasn't specified how.

INSKEEP: NPR senior national political correspondent Mara Liasson joins us now. Mara, good morning.


INSKEEP: In an interview last week to reassure voters that he's up to the job, Biden told George Stephanopoulos, watch me at this NATO summit. So we were watching. What did he do?

LIASSON: Well, you heard him give a ringing endorsement of the principles of the alliance. From the very same room, the Mellon auditorium, where the treaty was signed 75 years ago. In terms of style, you're right. Biden has been under a microscope since his disastrous debate with former President Donald Trump. This speech last night was from a teleprompter. He did deliver it clearly and firmly. In terms of substance, it was music to the ears of NATO leaders. Biden said there's a bipartisan commitment to the alliance. He quoted former Republican President Ronald Reagan, saying if fellow democracies are threatened, we are threatened, too. Of course, that's the idea behind Article 5, which is the beating heart of NATO. That's an attack on one, is an attack on all.

INSKEEP: Ah. How are Europeans viewing this moment?

LIASSON: Well, many European leaders are very nervous. This election represents an existential moment for NATO. The U.S. president wields tremendous, pretty much unchecked executive power when it comes to foreign policy. And the contrast, as you said, between Biden and Trump on NATO couldn't be clearer. Trump has had a consistent antipathy towards NATO. He had to be talked by his aides into staying in the alliance during his first term. He famously said he would let Russia do, quote, "whatever the hell they want" to NATO members who he thought didn't spend enough on their defense. And Biden last night, noted that under his leadership, NATO members have boosted their defense spending. Here's what he said.


BIDEN: The year 2020, the year I was elected president, only nine NATO allies were spending 2% of their defense GDP on defense. This year, 23 will spend at least 2%.


LIASSON: Biden is very, very proud of his legacy that under his watch, NATO has expanded. Sweden and Finland joined.

INSKEEP: Yeah, and not a small point that he mentions there. Trump's attack on NATO was built around the idea that they're not spending enough, which is a bipartisan idea. Obama said this, then Trump said it. President Biden is saying that most of them are now spending up to the levels that they committed to. But what does he say about the challenges the alliance faces now?

LIASSON: Biden said Russian President Vladimir Putin wants to wipe Ukraine off the map, and that Putin won't stop there. Biden said the U.S. and some other allies are going to be giving Ukraine more air defense systems. The contrast to Trump was implicit. Trump has been extremely positive towards Putin and negative towards Ukraine. Many Republicans in Congress were reluctant to provide more funding for Ukraine this year and held it up for months. Now, Ukrainian President Volodymyr Zelenskyy is at this summit. Today, he'll be meeting with Republican House Speaker Mike Johnson, and tomorrow he meets with Biden.

INSKEEP: Very briefly, where does he stand with the Democrats who are worried about his candidacy?

LIASSON: Well, he's dug in. He says he won't step aside, despite polls showing significant movement to Trump in the battleground states, and Democrats are beside themselves. They're worried they're going to lose the White House and the Republicans will keep the House and take the Senate.

INSKEEP: NPR's Mara Liasson, thanks so much.

LIASSON: You're welcome.


PFEIFFER: Ukraine's president is also here in Washington, meeting leaders of the alliance that his country would like to join.

INSKEEP: And he's saying that Russia will stop at nothing in its campaign to take over Ukraine. Zelenskyy spoke at the Reagan Institute here, reminding his audience of a missile strike on a children's hospital this week in the capitol Kyiv.


PRESIDENT VOLODYMYR ZELENSKYY: Russia always knows where its missiles hit, always - a direct hit on a hospital building.

PFEIFFER: NPR's Ashley Westerman has been monitoring reaction to that attack. She joins us from Lviv. Hi, Ashley.


PFEIFFER: How significant is it that this particular hospital was hit?

WESTERMAN: So the Okhmatdyt Hospital is Ukraine's largest pediatric hospital. It's known for treating child cancer and organ transplants. And the hospital CEO says the toxicology and trauma departments as well as Ukraine's only blood cancer treatment lab were destroyed in Monday's strike. Jarno Habicht is the World Health Organization country director for Ukraine, based in Kyiv.

JARNO HABICHT: It was devastating. We walked in the hospitals in several wards where equipment was damaged. We saw health care workers, patients, children with their parents in the shelter, but then also the ambulance was coming to take away the children to the new hospitals.

WESTERMAN: Now, Sacha, no children died, but two adults did. And two days later, rescuers are still trying to dig people out of the rubble. Now, Ukrainians are, of course, shocked and angry at what happened. But Habicht says Russian missiles hitting civilian infrastructure is not new.

HABICHT: WHO has monitored, verified, and reported 1,882 attacks on health. So we have seen numerous attacks through all this war over last two years.

WESTERMAN: And now, when these things happen, Russia typically says they were actually aiming at something else, and the hospital or clinic happens to get hit. And that's the same thing they said about what happened on Monday.

PFEIFFER: Ashley, you mentioned shock and anger, of course. What else are you hearing about reaction to the strike?

WESTERMAN: So Ukrainians are taking to the internet and saying, see? Russia even kills children to achieve their goals here. Outside of Ukraine, the condemnations have rolled in from Kyiv's allies. President Biden called the attack, quote, "a horrific reminder of Russia's brutality." The U.K.'s new Prime Minister, Sir Keir Starmer, said attacking a children's hospital was, in his words, "the most depraved of actions." And NATO Secretary General Jens Stoltenberg said it was a horrendous and heinous attack.

PFEIFFER: Speaking of NATO, the NATO summit is happening in D.C. right now, and long-term aid to Ukraine is on the agenda. Do Ukrainians have any sense of whether this hospital attack could move the needle at this summit in terms of getting more aid to Ukraine?

WESTERMAN: So Ukrainians would certainly like to think the attack has created some momentum in their favor. And President Volodymyr Zelenskyy is not going to let attendees of the summit forget it. But Michael Kofman at the Carnegie Endowment for International Peace is skeptical.

MICHAEL KOFMAN: My view of events of this type is that most of the substance tends to be agreed prior to the summit itself, and that the summit is more of a convening event than not.

WESTERMAN: So, really, Sacha, we'll just have to wait and see how the NATO summit goes.

PFEIFFER: That's NPR's Ashley Westerman in Lviv. Thank you.

WESTERMAN: Thank you.


INSKEEP: Some other news now - Texas executes more people than any other state, and it carries out those executions using one drug - a sedative called pentobarbital.

PFEIFFER: This morning, we have news of how Texas does that. Most major pharmaceutical companies refuse to provide their medicines for executions. States have passed laws allowing them to hide the names of companies involved.

INSKEEP: But NPR investigator reporter Chiara Eisner found and talked with a pharmacist who recently made the drug for Texas out of a pharmacy in San Antonio, and she's here in Studio 31 to talk about it. Chiara, good morning.

CHIARA EISNER, BYLINE: Good morning, Steve.

INSKEEP: So how did you find out which pharmacy made these drugs?

EISNER: Well, I looked at documents from the Drug Enforcement Agency and the Texas Department of Criminal Justice. There were clues in there that indicated it was a company in San Antonio called Rite Away Pharmacy and Medical Supply.


EISNER: They had been working with the state since at least 2019. Rite Away is what's known as a compounding pharmacy. That's a pharmacy that mixes its own drugs from raw ingredients, and those drugs that they make are not approved by the FDA.


EISNER: I talked with former workers at the company and eventually called one of the owners, Rohit Chaudhary. He confirmed his company provided lethal drugs to the state, but said another pharmacist was mostly responsible. So then I called that pharmacist, and he was honest about being the one who mixed the ingredients together and prepared the pentobarbital injections. He did say the work bothered him at times, but that he had made peace with it.

UNIDENTIFIED PERSON: I guess I satiated my guilt with the knowledge that, you know, whatever they did was deserving of capital punishment. And I'm not the one who decided that they would get that punishment. I was just the one that provided the means for it.

INSKEEP: Really interesting glimpse into the life of someone who participates in this process, and also into this pharmacy, which has an interesting track record in Texas.

EISNER: That's right. During the time that it was making this drug, and as Texas executed more than 20 people, inspection documents from the Texas State Board of Pharmacy indicated that Rite Away violated state rules, some of them around cleanliness and sterile drug preparation, more than a dozen times. And then in 2022, the U.S. Department of Justice sued another Rite Away branch because it, quote, "fueled and profited from the opioid epidemic." Attorneys there alleged at least one person died from an overdose shortly after the pharmacy prescribed her a high amount of fentanyl. The company denied liability, but paid a $275,000 fine.


EISNER: Critics of the death penalty say pharmacies with histories like that shouldn't be trusted by states to make drugs used in executions.

INSKEEP: But they're doing the work. Why did they agree to do this work?

EISNER: It could have been for the money, but here's the pharmacist again, who we've agreed to keep anonymous.

UNIDENTIFIED PERSON: It was probably in the very low five digits. It was not a big moneymaker at all. And even had guys from DOC saying, you know, you can charge more for this.

EISNER: The Department of Criminal Justice declined to talk about any of this with me. Texas plans to execute a prisoner named Ruben Gutierrez with pentobarbital on July 16. I asked whether the state intends to use drugs from Rite Away to stop his heart next week, but the Department of Criminal Justice declined to comment on that too.

INSKEEP: Okay, Chiara Eisner of NPR's investigations team, thanks so much.

EISNER: Thanks. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Steve Inskeep is a host of NPR's Morning Edition, as well as NPR's morning news podcast Up First.
Sacha Pfeiffer is a correspondent for NPR's Investigations team and an occasional guest host for some of NPR's national shows.