Under Hopkins the administration of Lend-Lease was diffuse and controversial. It essentially bypassed the State Department, and Secretary Cordell Hull was not happy to be left out of the loop. Hopkins came to be called "Roosevelt’s own personal foreign office." The situation was quite irregular, Sherwood admitted, "but so was the fundamental situation in which the United States found itself at the time." Lend-Lease’s quasi-governmental status suited its manager’s unbureaucratic style perfectly, and Hopkins, quite simply, got things done. His trademark tool was the telephone, and he never hesitated to call and berate high-ranking military officers for failing to meet production deadlines. In 1941, for example, when a strike at the Universal Cyclops Steel Corporation stalled the delivery of propellers for navy planes, Hopkins ordered photos of the prop-less planes to be taken for publication in the newspapers.

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Hopkins had brought back from his meeting with Churchill the conviction that the prime minister and Roosevelt must soon meet face to face. He was maneuvering to set up such a meeting when, in June 1941, Germany dramatically altered the world picture by invading the Soviet Union. A key factor in British defense planning–the central issue to be discussed at the impending conference–was ascertaining how long Russia would be able to hold off the Germans. "The question of assistance to the Soviet Union was a ticklish one," wrote FDR biographer Nathan Miller. "Public opinion was hostile, and many Americans preferred to let the twin devils of Nazism and Communism fight to the death." To Roosevelt and Churchill, however, aiding the Soviet Union meant help in defeating Germany, provided the Soviet Union could survive the Nazi onslaught. Hopkins volunteered to fly to Moscow to find out for himself.

Hopkins met alone with Joseph Stalin and in two days dramatically increased Western understanding of the Soviet situation. "I had no conversations in Moscow," he reported, "just six hours of conversation. After that there was no more to be said. It was all cleaned up at two sittings." Stalin’s confidence and straightforward manner impressed Hopkins, who came away convinced that the Soviet Union would blunt the German advance. The Soviet dictator was equally impressed with Hopkins, whose diplomatic efforts helped Roosevelt obtain Lend-Lease aid for the Soviet Union.

In August 1941, with Hopkins the principal go-between, Roosevelt and Churchill met at sea off the coast of Newfoundland for the Atlantic Conference, where they drafted and signed the Atlantic Charter. A joint declaration by Roosevelt and Churchill, the document stated that their two nations sought no additional territory and that they hoped to assure that "all the men in all the lands may live out their lives in freedom from fear and want." It called for the disarmament of the Axis powers and also set ground rules for the establishment of peace. Essentially, it united American and British policies and also brought the Soviet Union into the ring.

During the years 1941-1943, Hopkins could usually be found in his room at the White House, working in a bath-robe, with letters, papers, telegrams, and diplomatic dispatches strewn across his bed. It was common knowledge that Hopkins was desperately ill. In addition to the piles of official papers, his room was littered with medicines. He also was required to follow a strict diet that his wide-ranging activities made nearly impossible. Rexford Tugwell wrote that Hopkins seemed to hold himself together in 1943 through "sheer nerve."

As the war progressed, Hopkins’ health grew progressively worse. His condition prevented his digestive system from absorbing enough fats and proteins, and Hopkins appeared more and more cadaverous despite regular blood transfusions. On New Year’s Day 1944, he fell seriously ill and never really recovered. In February he received the news that his son Stephen had been killed in action in the Pacific. Able to work only two or three hours a day, Hopkins became less of a factor in Roosevelt’s planning.

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