The early going favoured Trump, 78, who appeared forceful and energetic when compared to the 81-year-old Biden, who spoke in a hoarse, halting voice and coughed regularly.
Trump jabbed Biden for being incoherent, saying at one point: “I really don’t know what he said at the end of that sentence. I don’t think he knows what he said”.
The White House said during the debate that the president was suffering from a cold, while a Democratic strategist who worked on Biden’s 2020 campaign called it a “disaster”.
Biden began to find his footing later in the debate as he attacked Trump’s character. “The idea that I would apologise to you?” Biden asked at one point, incredulous after Trump accused him of mistreating veterans.
“You’re the sucker. You’re the loser,” Biden told Trump.
Each suggested the other was a criminal.
“The only person on this stage who is a convicted felon is the man I’m looking at right now,” Biden said and then accused Trump of having sex with porn star Stormy Daniels.
The bad blood between the two men was on display from the start when they eschewed the traditional handshake. Biden frequently referred to Trump as “this guy” and chuckled at some of his opponent’s more hyperbolic statements.
Sparring over the economy
Both candidates blamed the other for the number one issue on voters’ minds: inflation.
Biden accused Trump of leaving him a “terrible” economy in response to the moderators’ first question about rising prices paid by consumers.
Trump replied that Biden’s handling of the Covid-19 pandemic was a “disaster” and said inflation was “absolutely killing us”.
He blamed the pandemic for wrecking the economy and his shot at re-election. “Everything was rocking good,” he said.
Voters, right now, seem to be agreeing more with Trump than Biden, with polls showing they favour Trump’s handling of the economy.
Biden’s challenge on Thursday was to make clear to viewers that his administration is the one that dug the country out of the pandemic-induced hole.
“There was no inflation when I became president,” Biden said. “You know why? The economy was flat on its back.”

Losing his train of thought
Biden seemed to lose his train of thought while responding to a question about the national debt.
His voice trailing off several times, Biden first referred to “billionaires” as “trillionaires” before correcting himself.
Then, while arguing that the wealthy should pay more tax, he seemed unable to complete his sentence, pausing for an extended awkward moment, before ending his thought in a way that sounded nonsensical.
Tax reform would create money to help “strengthen our healthcare system, making sure that we’re able to make every single solitary person eligible for what I was able to do with the, with the Covid, excuse me, with dealing with everything we had to do with,” Biden said before pausing.
“We finally beat Medicare,” Biden said, likely referring to Covid-19.
Trump pounced.
“He’s right. He did beat Medicare. He beat it to death.”
Trump’s vow on abortion
Abortion is an issue Democrats think could help deliver a victory in November. Trump in 2016 campaigned on overturning Roe vs Wade, and as president appointed three Supreme Court justices who provided the deciding votes revoking the 49-year right to the procedure.
In response to a question from the moderators, Trump vowed not to go further if he returns to the White House, where his administration would have the authority to outlaw the abortion pill mifepristone, which is widely used.
Overturning Roe is one of Trump’s greatest political vulnerabilities, but on Thursday the former president contended everyone was happy with what he did.
“As far as abortion’s concerned it’s back to the states,” Trump said, contending the Founding Fathers would have been happy with the end of Roe. “Everybody wanted it brought back.”
That’s not true. Polls have shown significant opposition to overturning Roe and voters have punished Republicans in recent elections for it. “The idea that the founders wanted the politicians to be the ones making the decisions about women’s health is ridiculous,” Biden shot back.
In a unanimous decision this month, the Supreme Court preserved access to mifepristone, a pill that was used in nearly two-thirds of all abortions in the US last year.
Until Thursday, Trump had not detailed his position on access to the medication, but during the debate he indicated he supported the justices’ decision, saying: “I will not block it”.

Israel-Gaza war
During a discussion of Israel’s war against Hamas, Biden walked a tightrope. The president sought to both stress his support for Israel in the wake of the deadly October 7 attack by Hamas, designated a terrorist group by the US and European Union, and his push for more restraint in Israeli military operations in Gaza.
Israel’s campaign there to root out Hamas has sparked a humanitarian crisis and divided Democrats, unleashing criticism over Biden’s handling of the war from young voters and progressives, key parts of the party’s electoral coalition.
Hamas cannot be allowed to continue, Biden said.
Trump said Israel should be allowed to “finish the job”.
“He’s become like a Palestinian, but they don’t like him because he’s a very bad Palestinian, he’s a weak one,” Trump said.
Biden responded: “I’ve never heard so much foolishness”.
Ending the Ukraine war before January
Trump blamed Biden for the war in Ukraine and called on Europe to up spending to support Kyiv.
Russian President Vladimir Putin “would have never invaded Ukraine” if the United States “had a real president,” Trump said.
Trump again claimed he would be able to “settle” the war if re-elected, even ahead of January 20, when he would be inaugurated if he won the presidency. He did not say how he would achieve that, however.
Trump also demanded that Biden pressure European allies to spend more on supporting Ukraine.
When asked whether Russia’s terms for ending the war were acceptable, Trump said they were not.
When it was his turn, Biden called Putin “a war criminal”, as he has repeatedly done before. “He’s killed thousands and thousands of people,” Biden said, warning that the Russian leader would not stop after taking Ukraine.

Trump asked if he will accept 2024 results
Though asked three times, Trump never directly affirmed that he would accept the election results, no matter who wins.
Several times Trump noted that he would accept the results “if it’s a fair and legal and good election” but wouldn’t give a “yes” or “no” answer to moderator Dana Bash’s inquiries.
The follow-ups came after Trump ultimately denounced political violence as “totally unacceptable”.
After the moderator asked Trump three times whether he would accept the results of the November election, Biden responded that he doubted Trump would “because you’re such a whiner”.
Biden noted there was no evidence of any widespread fraud in the 2020 election and that multiple courts had dismissed challenges brought by Trump’s campaign.
Golf: who is better?
The debate also degenerated into a squabble over golfing prowess.
“He can’t hit a ball 50 yards,” said Trump, on one of the few occasions the two men directly addressed each other.
“He challenged me to a golf match. He can’t hit a ball 50 yards.”
Trump’s own vitality was never in question, he boasted, insisting “I’m in as good a shape as I was years ago”.
Not to be outdone over his putting prowess, Biden insisted he was game on the green.
“I’d be happy to have a driving contest,” he said. “I got my handicap when I was the vice-president down to a six.”
Trump scoffed.
“A six handicap?” he snorted. “I’ve seen your swing. I know your swing.”
Reuters, dpa, Agence France-Presse and Associated Press