--:-- [Up First theme music plays]
--:-- Ian Martinez: The U.S. southern border is a top issue for voters and a potential liability for President Biden.
--:-- Michelle Martin: Today, Biden is expected to issue an order that could limit the flow of people across the border. Could this also limit the political fallout for him?
--:-- Ian Martinez: I'm Ian Martinez with Michelle Martin, and this is Up First from NPR News.
--:-- Ian Martinez: Results are streaming in from the world's biggest election. India is still counting the more than 640 million votes cast in an election that's gone on for more than six weeks and appears Prime Minister Modi has won another five years in power.
--:-- Michelle Martin: And people suffering from post-traumatic stress disorder don't have many treatment options to turn to. Today, the FDA will review whether an illegal party drug could provide relief.
--:-- Ian Martinez: If not MDMA, there really is nothing else out there in the pipeline.
--:-- Michelle Martin: Stay with us. We've got the news you need to start your day.
--:-- Ian Martinez: This message comes from BetterHelp.
--:-- President Fernando Madeira: For me, sometimes I just need to go and talk to somebody that is not going to judge me, right? It's going to be there and they're going to listen to me. And I can't start just saying, look, I'm not feeling right today. And it feels natural.
--:-- Ian Martinez: You can do all that with the all-new Adobe Acrobat Studio. Learn more at adobe.com slash do that with Acrobat.
--:-- Michelle Martin: The large number of asylum seekers at the southern border has become a political headache for President Biden in this election year.
--:-- Ian Martinez: A few months ago, a bipartisan group of senators worked with the White House to negotiate a compromise that would have addressed this issue, but Republicans walked away from the deal.
--:-- Michelle Martin: So today, President Biden is expected to announce actions he will take through executive order, and he has invited several mayors of border cities to join him at the White House.
--:-- Ian Martinez: NPR immigration correspondent Sergio Martinez Beltran is joining us this morning to tell us more about this.
--:-- Sergio Martinez Beltran: Good morning, Michelle. Good morning.
--:-- Michelle Martin: Do we have any details yet? Has the White House said anything publicly?
--:-- Sergio Martinez Beltran: So we don't know much about it yet, but we do know, Michelle, that ever since the Senate failed to pass a measure, the White House has said it would consider taking executive action.
--:-- Michelle Martin: And the Biden administration has been piecemealing restrictions for the last few weeks. For example, he recently announced a new rule intended to speed up the removal of some migrants who are not eligible for asylum.
--:-- Sergio Martinez Beltran: And what Biden is expected to announce today would also limit asylum claims. The expectation is that Biden will invoke and rely on, and bear with me here because it's going to sound clunky, Section 212F of the Immigration and Nationality Act.
--:-- Michelle Martin: I talked to Lily Axelrod, who is an immigration attorney based in Memphis, Tennessee. Here's how she described it.
--:-- Sergio Martinez Beltran: So Section 212F is a fairly broad provision that grants the president authority to restrict immigration and visitors non visitors from coming into the United States when he thinks or she thinks that they detrimental to the interests of the United States.
--:-- Michelle Martin: In the past, this section has been used on the grounds of national security. The provision would also allow the president to suspend entries once the number of unauthorized crossings reaches a certain daily threshold.
--:-- Sergio Martinez Beltran: And this could be the most impactful border management policy to come out of this administration so far. But it's widely expected that it will face court challenges.
--:-- Michelle Martin: I got it. Okay, so can you tell us how the southern border looks in terms of unauthorized crossings at the moment? I mean, it's way different than how it looked last year.
--:-- Sergio Martinez Beltran: Back then, we saw a record number of unauthorized crossings, and many of these migrants were seeking asylum. But those numbers have plummeted this year.
--:-- Michelle Martin: And the reason for that, according to immigration policy analysts, is Mexico.
--:-- Sergio Martinez Beltran: Mexico has been cracking down on illegal migration at the urging of the U.S.
--:-- Michelle Martin: But at the same time, we know that border communities have been challenged by this influx of migrants going back, what is it, sort of some years now.
--:-- Sergio Martinez Beltran: You've been talking to mayors of these cities. What are they saying?
--:-- Michelle Martin: Well, I reached out to a bunch of border mayors, and some of them have been invited to today's announcement at the White House.
--:-- Sergio Martinez Beltran: El Paso Mayor Oscar Leiser will be there. He told me in a statement that his city is a welcoming place, but that no community can continue the resources expended on this humanitarian crisis.
--:-- Michelle Martin: So he says he's looking forward to hearing from Biden.
--:-- Sergio Martinez Beltran: We know that the mayors of San Diego, California and Yuma, Arizona were also invited.
--:-- Michelle Martin: And then, there are some mayors who say they were not invited, like the mayor of Eagle Pass, Texas, a community that saw some of the highest number of unauthorized migrants last year.
--:-- Sergio Martinez Beltran: Mayor Rolando Salinas told me he wishes this policy rollout had been done back in December, when his city saw about 2,000 to 3,000 migrants per day.
--:-- Michelle Martin: He says, quote, we won't forget those days.
--:-- Sergio Martinez Beltran: Sergio Martinez Beltran is NPR immigration correspondent.
--:-- Sergio Martinez Beltran: You're welcome.
--:-- Michelle Martin: After six marathon weeks of voting across India, where nearly one billion people were eligible to vote, to cast a ballot or press buttons on an electronic voting machine, counting is now underway to tally the results.
--:-- Ian Martinez: And initial results suggest that the Prime Minister Narendra Modi of the BJP party will become Prime Minister for the third time.
--:-- Michelle Martin: On the line with us now to tell us more is NPR's Dia Khadid.
--:-- Dia Khadid: Hi, Michelle. How are the numbers looking so far?
--:-- Michelle Martin: Well, so far, a tally by India's election commission indicates that Modi's party, it's called the BJP, has won the largest number of seats in parliament.
--:-- Dia Khadid: It hasn't won a clear majority, but with its allies, it looks like it will be able to form a coalition government.
--:-- Michelle Martin: On the flip side, India's opposition alliance has done better than exit polls expected, but it hasn't won enough seats to form government, according to the count so far.
--:-- Dia Khadid: So essentially, it's a victory for the BJP and a victory for the Prime Minister, yet again.
--:-- Michelle Martin: Yes, but you know, I'm on the ground in the capital, New Delhi, and if you were here just judging by the mood outside each of the campaign headquarters, you would say that Modi's BJP had lost and the opposition won.
--:-- Dia Khadid: And that's because at the outset of these elections, Modi promised that his party would win a super majority The exit polls predicted Modi party would nearly hit those numbers
--:-- Michelle Martin: And so outside the BJP headquarters we saw a man seemingly pray to a Modi God beseeching him to come back to power.
--:-- Dia Khadid: And so unless there's a dramatic change as counting continues, yes, Modi will return to power.
--:-- Michelle Martin: He will be the only prime minister, after the founder of modern India, Jawaharlal Nehru, to win three times.
--:-- Dia Khadid: But he'll rule as a part of a coalition, not as this seemingly unstoppable juggernaut led by a man who recently suggested to a journalist that he was chosen by God.
--:-- Michelle Martin: So, Dia, what does this mean for India going forward?
--:-- Dia Khadid: Well, Michelle, I think it will be harder for Modi and his party to continue their vast recasting of India. as a country that elevates its Hindu majority above other citizens.
--:-- Michelle Martin: Harder but not impossible.
--:-- Dia Khadid: It also appears to have signaled to the opposition, which is led by the Congress Party, that power is within reach.
--:-- Michelle Martin: That party is led by Rahul Gandhi, the great-grandson of India's first prime minister.
--:-- Dia Khadid: It used to dominate Indian politics, but it's waned in recent years, and under Rahul's leadership, the party shrank and shrank.
--:-- Michelle Martin: But in these elections, the party looks like it won double the seats that it did in the previous ones.
--:-- Dia Khadid: So now Rahul can show voters that he and the Congress Party can fight back.
--:-- Michelle Martin: And critics say that will also likely shake Indian institutions, which critics say were increasingly partial to Modi and his party in recent years, like the mainstream media, YouTube news outlets, influencers, law enforcement agencies, and even India's election commission itself.
--:-- Dia Khadid: That is NPR's Dia Khadid in New Delhi.
--:-- Dia Khadid: Thank you so much.
--:-- Michelle Martin: Thank you, Dia.
--:-- Michelle Martin: MDMA is what we're going to talk about now. That's a party drug. It's usually associated with all-night raves, but one company is seeking FDA approval to use it as a mainstream treatment in mental health care.
--:-- Ian Martinez: Yeah, today a panel of experts to the Food and Drug Administration will review the evidence behind using MDMA to treat post-traumatic stress disorder, what they say could affect whether the agency approves the treatment.
--:-- Michelle Martin: NPR's Will Stone is with us now to tell us more about this.
--:-- Will Stone: Good morning.
--:-- Michelle Martin: So this treatment is called MDMA-assisted therapy. How does it work?
--:-- Will Stone: Well, it basically combines a form of talk therapy with the psychedelic drug MDMA.
--:-- Michelle Martin: So a patient with PTSD gets a dose and then works through their trauma with two therapists.
--:-- Will Stone: The clinical trial involved several of these dosing sessions.
--:-- Michelle Martin: FDA staff have said based on that data, participants appear to experience, quote, rapid, clinically meaningful, durable improvement in their PTSD symptoms.
--:-- Will Stone: I asked Dr. Mason Marks about the chances of approval for MDMA.
--:-- Michelle Martin: He studies psychedelics at Harvard and Florida State University.
--:-- Will Stone: At first glance, data looks promising. There are also legitimate questions.
--:-- Michelle Martin: But just looking at the totality of the circumstances, I suspect it will be approved.
--:-- Will Stone: In fact, the drug company that's funded this research called Lycos Therapeutics has raised more than $100 million ahead of possible FDA approval.
--:-- Michelle Martin: So Dr. Marks referred to legitimate questions. What are those questions?
--:-- Will Stone: That's right. This is not a done deal because there are questions about whether the findings from the trials are solid
--:-- Michelle Martin: And one big concern is that most people in the trials could tell whether they received MDMA or a placebo
--:-- Will Stone: Ideally, in clinical trials, people can't tell.
--:-- Michelle Martin: Obviously, that's hard to do with psychedelics, but ultimately, when this does happen, it can lead to bias and that skews the results.
--:-- Will Stone: There are other concerns about the methods and long-term data, but what's caught attention more recently are inflammatory allegations about the trials.
--:-- Michelle Martin: Okay, so what are those?
--:-- Will Stone: Essentially, there are claims that some therapists and investigators may have pushed patients to report good results and overlooked adverse events.
--:-- Michelle Martin: That was emphasized in a recent report from the Institute for Clinical and Economic Review.
--:-- Will Stone: This is an independent group that did a deep dive into the data and said there were substantial concerns about the validity of the results.
--:-- Michelle Martin: Some of that is based on what trial participants have said.
--:-- Will Stone: Sarah McNamee was in one of the trials. Take a listen to part of her public testimony read by a friend.
--:-- Will Stone: Three months after I was given my first dose of MDMA, I was for a time one of the staunchest advocates for MDMA therapy.
--:-- Michelle Martin: The problem is that I was also suicidal and clinically decompensating in drastic and unprecedented ways.
--:-- Will Stone: And what she means by that is basically she was having worsening symptoms.
--:-- Michelle Martin: And McNamee says her therapist played up the idea that she was helping make history.
--:-- Will Stone: And she says others in the trials have also shared with her negative experiences that did not get fully captured in the published findings.
--:-- Michelle Martin: As it turns out, there was a petition calling for this FDA public meeting, in part because of these kind of concerns.
--:-- Will Stone: So what could this mean for possible approval of the treatment?
--:-- Michelle Martin: The drugmaker Lycos has pushed back on these allegations and said they stand by their results.
--:-- Will Stone: Therapists in the trials have also said this outside report was based on hearsay and misrepresentations.
--:-- Michelle Martin: And there are certainly many who do feel MDMA should be approved, including groups representing military veterans.
--:-- Will Stone: Here's former Army Ranger Jesse Gould with the nonprofit called Heroic Hearts Project.
--:-- Jesse Gould: If not MDMA, there really is nothing else out there in the pipeline.
--:-- Michelle Martin: So yes, there may be flaws in the study, but what is the risk-reward of potentially saving millions of lives?
--:-- Will Stone: So this panel of advisors will have to weigh all of this because the FDA wants to make a decision by early August.
--:-- Michelle Martin: That is NPR's Will Stone.
--:-- Will Stone: Thank you.
--:-- Michelle Martin: Thank you.
--:-- Michelle Martin: And that's Up First for Tuesday, June 4th.
--:-- Ian Martinez: I'm Michelle Martin. And I'm Amy Martinez.
--:-- Michelle Martin: Listen to Consider This from NPR.
--:-- Ian Martinez: The Pentagon is trying to cut health care costs by outsourcing service members' care to the private sector.
--:-- Michelle Martin: What could that mean for the future of battlefield medicine? Find out on Consider This.
--:-- Ian Martinez: Today's episode of Up First was edited by Alfredo Carbajal, John Helton, Jane Greenhalgh, Ally Schweitzer and Alice Woelfle.
--:-- Michelle Martin: It was produced by Ziad Buchh, Ben Abrams and Milton Guevara.
--:-- Ian Martinez: Our technical director is Zac Coleman, with engineering support from Arthur Laurent.
--:-- Michelle Martin: Join us again tomorrow.
--:-- Ian Martinez: This message comes from Ritual.
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--:-- Michelle Martin: What makes Ritual vitamins different? Ritual vitamins are made with bioavailable, clinically studied key ingredients, as well as the essence of mint.
--:-- Ian Martinez: Get 25% off your first purchase when you visit ritual.com slash NPR.
