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One year of war in Ukraine; China wants peace; access to an abortion drug is at risk

STEVE INSKEEP, HOST:

How has a year of war transformed Ukraine?

A MARTÍNEZ, HOST:

One year ago, Russia's invasion was so hard to imagine that many analysts dismissed the idea. Russia itself mocked U.S. warnings of invasion. Apparently, even some Russian soldiers didn't understand what they were doing until the shooting started. Now Ukraine faces the daily reality of the largest European war since 1945.

INSKEEP: NPR's Joanna Kakissis has covered much of that war and is on the line. Hey there, Joanna.

JOANNA KAKISSIS, BYLINE: Hey, Steve.

INSKEEP: What's it like to be in Kyiv today?

KAKISSIS: Well, this is a very somber day here in Kyiv and all - and throughout all of Ukraine. Let's remember, thousands of people have died during the last year. Millions of people are refugees. They've been displaced. Russian forces have been - have destroyed entire cities and looted museums and dropped missiles on schools - just devastation everywhere. And the invasion has also made life very unpredictable, very painful, very tense. This invasion has also united Ukrainians. And so the government is holding a series of events today to acknowledge these deep feelings of pain and defiance.

(SOUNDBITE OF BELLS RINGING)

KAKISSIS: And those are the bells of St. Michael's Cathedral. And this is where we met Olha Komarnytska. She said her husband, Ivan, was killed on the front lines three months ago. She was at a ceremony today where his portrait was hung on a memorial wall for fallen soldiers.

OLHA KOMARNYTSKA: (Through interpreter) Today I have no words. It's hard. It's complicated. This year has gone by as if it were a month, a long, long month. I can't even bring myself to say the name Russia.

KAKISSIS: So President Volodymyr Zelenskyy called this the longest day of our lives in an early morning video address, and he's expected to speak again later today.

INSKEEP: So that's what it's like to be in Kyiv. How are other countries observing this one-year mark?

KAKISSIS: Well, you know, Ukrainians are worried that Russians will mark this day with even more attacks. Meanwhile, the United Nations General Assembly yesterday overwhelmingly passed a resolution asking for an immediate withdrawal of Russian troops from Ukraine. And yesterday, there were very public signs of support in major cities. In London, activists painted the street outside the Russian embassy in blue and yellow, the colors of the Ukrainian flag. And in Brussels, pro-Ukraine demonstrators filled a neighborhood with teddy bears, representing the thousands of Ukrainian children who have been forcibly removed - who have been forcibly moved to Russia.

INSKEEP: So that is how the world is marking this day. What do you hear from Ukrainians about the immediate future?

KAKISSIS: So I saw a public opinion poll the other day that said that nearly 80% of Ukrainians believe that Ukraine is going to win. And by win, they mean reclaim every inch of territory that Russia has occupied since 2014, including the southern peninsula of Crimea. The West has given - let's remember, the West has given Ukraine billions in military and humanitarian aid. Western weapons have helped Ukrainian forces hit Russian targets and reclaim occupied territory. And Western aid has helped Ukraine restore some of its power grid after it was almost destroyed during months of Russian strikes. Ukrainians are very grateful for all this, and they want to show the West and the Kremlin and even themselves that they are rebuilding, even as Russia continues to attack.

INSKEEP: NPR's Joanna Kakissis, thanks so much.

KAKISSIS: You're welcome, Steve.

(SOUNDBITE OF MUSIC)

INSKEEP: OK. Now, on this anniversary, China says it's seeking a way out of Russia's war in Ukraine.

MARTÍNEZ: Yeah, Chinese officials released a so-called position paper calling for a cease-fire. Now, their gesture comes - their gesture at peace comes during the same week that the U.S. warned that China might intensify the war. They could send weapons to Russia. Analyst Robert Daly told NPR that China is trying to prop up one of its few powerful friends.

ROBERT DALY: The posture of peacemaker is very important for Xi Jinping, both before the world and before his own people. But he also sees himself in an existential competition with the United States, for which he needs Russia.

INSKEEP: One way or another, China wants Russia to come out OK. NPR China affairs correspondent John Ruwitch is in Beijing. Hey there, John.

JOHN RUWITCH, BYLINE: Good morning.

INSKEEP: So what exactly was in this position paper?

RUWITCH: Well, there were 12 points. They were really broad principles. And they included things like, you know, hostilities should end and peace talks should get underway. It says all parties should create conditions for negotiations and support dialogue between Russia and Ukraine so they can gradually de-escalate this conflict. Now, some of these points did seem to be targeted at Russia. It said nuclear arms must not be used and that the threat to do so must be opposed. It also said China is opposed to attacks on nuclear power plants. And you'll recall that there was fighting around the Zaporizhzhia nuclear plant not that many months ago. But there were also points clearly targeting the U.S. and the West, calling for an end to unilateral sanctions, for instance, or abandoning the, quote, "Cold War mentality."

INSKEEP: OK, that's very interesting as a public document, since it shows China pushing at least a little bit on both sides, trying to be a kind of mediator or peacemaker...

RUWITCH: Right.

INSKEEP: ...As Mr. Daly said earlier. But would this document have any impact?

RUWITCH: That's a key question. I mean, the government has talked it up in recent days, but it's not entirely clear to what end. I asked Ian Chong about this. He's an associate professor of political science at the National University of Singapore, and he was kind of scratching his head, too.

CHONG JA IAN: There isn't much leverage involved. The document lays out broad general principles but no real reason why you might want to cease and desist, right? There's no big appeal that you're getting something. There's no big cost if you don't comply.

RUWITCH: His best guess is that it's an attempt by Beijing to project an image to a domestic audience, perhaps to others, that China is a global player. It's being constructive. It's standing up for peace. None of the points in this document, it has to be said, are new, which is a little bit puzzling. And in Chong's words, you know, it's unclear if this position paper is a punch line or if it's setting the stage for more to come.

INSKEEP: John, what do you make of the nearly simultaneous U.S. accusations that China, the peacemaker here, is considering providing lethal assistance to Russia, which would extend the war?

RUWITCH: We don't know much about what China's plans are. I've talked with people that think China would never do something like this. Others think China may go there if it looks like Russia is on the ropes and is about to be defeated, you know? That's because there's this strong belief here that if Russia is defeated, if it's weakened in the wake of a war, that the West - that the U.S., really - will be able to focus on trying to contain China more. You know, by all accounts, China was surprised by the Russian invasion a year ago, but it stuck by Moscow. It hasn't condemned the invasion. Trade with Russia, for instance, has risen sharply over the course of the war. So, you know, this potential of China changing tacks, really, and providing lethal support would be a pretty big new irritant in U.S.-China relations and in China's relations with the EU. I will note, though, that when asked about it, China's foreign ministry says China wants peace. It accuses the U.S. of spreading false news and of fanning the flames of conflict by providing arms to Ukraine.

INSKEEP: NPR's John Ruwitch, always appreciate your insights. Thanks.

RUWITCH: You're welcome.

(SOUNDBITE OF MUSIC)

INSKEEP: OK, abortion pills could soon become much more difficult to obtain, even in states where abortion remains legal.

MARTÍNEZ: A federal lawsuit challenges the FDA's approval of an abortion drug that's been used for decades. Lawyers are submitting their final arguments to the judge today that has some reproductive health care providers looking for other options.

INSKEEP: NPR's Sarah McCammon is following the case. Sarah, good morning.

SARAH MCCAMMON, BYLINE: Good morning, Steve.

INSKEEP: How did this come before the judge? What's it about?

MCCAMMON: Well, it's about abortion pills, medication abortion, which is now the most common form of abortion in the U.S. And it's targeting a protocol that's used by about 98% of people here. According to the Guttmacher Institute, this two-drug regimen that was first approved by the Food and Drug Administration in 2000 is used by 98% of people, and it's approved to terminate pregnancies up to about 10 weeks. Now, a group of abortion rights opponents is arguing the abortion pill mifepristone, which is part of that protocol, was improperly approved, and they're asking a federal judge in Texas to overturn that approval.

INSKEEP: OK, so what happens if the judge says, wait a minute, this is no longer an FDA-approved drug?

MCCAMMON: Well, it would take away that option. And again, just to explain a little bit, it involves taking two drugs - first...

INSKEEP: Right.

MCCAMMON: ...Mifepristone, then misoprostol - in combination to end a pregnancy. That second drug I mentioned, Steve - I know they sounds similar, but misoprostol - it's widely used around the world on its own to end pregnancies, and it is widely available in the U.S. for other uses, off-label uses - labor and delivery, IUD insertion, things like that. And it is still likely to be available regardless of what happens with this case, even if that first drug goes away. I talked to Farah Diaz-Tello, senior counsel at If/When/How, which is a legal group that supports abortion rights. And here's how she explained it.

FARAH DIAZ-TELLO: The use of misoprostol for obstetrical and gynecological indications is already considered off-label, which doesn't mean illegal. Off-label use of medications is something very common. It happens every single day. As long as it's within the standard of care, there isn't a problem with it.

MCCAMMON: And because of the threat to mifepristone from this lawsuit, abortion providers around the country say they're preparing to switch, if needed, to that single-drug protocol, misoprostol alone.

INSKEEP: Well, what is known about the second drug, the one that's being challenged here?

MCCAMMON: Most providers say that based on decades of data from around the world, it is safe and can be quite effective, but not as effective as the two-drug protocol that's being challenged. If you only use misoprostol, there is a greater risk of nausea, cramping, bleeding. Dr. Asma Upadhyay at the University of California, San Francisco, says if that two-drug protocol is no longer available, the next best option for some people may actually be a surgical abortion.

USHMA UPADHYAY: I think it's going to be a huge learning curve for clinicians to figure out. What's the best right protocol for this patient? How should I counsel this specific patient based on their legal risks and based on how far they traveled to get here?

MCCAMMON: And - Steve, and another sign of just how concerned reproductive rights advocates are about this lawsuit, Vice President Kamala Harris is hosting a meeting later this morning with reproductive rights advocates to discuss mifepristone availability and other threats to abortion access.

INSKEEP: NPR's Sarah McCammon, thanks so much.

MCCAMMON: Thank you.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.