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Amanpour
Making Domestic Terror A Federal Crime; White Nationalism Top Agenda; Peter Neumann, Author, "Bluster: Donald Trump's War on Terror," Is Interviewed About Domestic Terror; Entering A New Nuclear Arms Race; Ernest Moniz, Former U.S. Energy Secretary, Is Interviewed About Nuclear Threat; How Russia Manipulates The Truth To Control Population; Incitement, Violence, Real Death And Killings Manifested Online And In Reality; Peter Pomerantsev, Author, "This Is Not Propaganda," Is Interviewed About Terrorism And Russia; The Age Of Disinformation And Fake News; The Threat Of Nuclear Weapons As Tensions Rise Between India And Pakistan; Dissecting The Ethical Implications Of A Pioneering Cancer Treatment. Aired 1-2p ET
Aired August 06, 2019 - 13:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
(COMMERCIAL BREAK)
[13:00:00] CHRISTIANE AMANPOUR, CNN INTERNATIONAL HOST: Hello, everyone, and welcome to AMANPOUR. Here's what's coming up.
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: Within that category, the majority are White supremacists' extremist motivated.
(END VIDEO CLIP)
AMANPOUR: White nationalism at the top of the agenda now. But will domestic terrorism become a federal crime?
And --
(BEGIN VIDEO CLIP)
DONALD TRUMP, U.S. PRESIDENT: We always have to be in the lead. You know, I've redone our nuclear. We have new nuclear coming.
(END VIDEO CLIP)
AMANPOUR: Are we entering a new nuclear arms race? I ask Earnest Moniz, nuclear physicist, former energy secretary and technical wiz behind the
Eran nuclear deal.
Plus, shining a light onto these dark ages of disinformation. Author and journalist, Peter Pomerantsev, and the war against reality.
Then --
(BEGIN VIDEO CLIP)
SIDDHARTHA MUKHERJEE, ONCOLOGIST: So, you don't want to treat a person who doesn't have a disease. But you also don't want to ignore the fact that
they have a propensity --
(END VIDEO CLIP)
AMANPOUR: The ethical implications of a pioneering cancer treatment. Author and oncologist, Siddhartha Mukherjee, gives us a glimpse of the
future of medicine.
Welcome to the program, everyone. I'm Christiane Amanpour in London.
The United States is, of course, still reeling after the twin mass murders in Dayton, Ohio and El Paso, Texas, which killed at least 31 people over
the weekend.
As the vigils for the dead grow, so too do demands for action. Among them, among those raising their voice is the FBI Agents Association which is
calling for a domestic terrorism statute, they said would "ensure that FBI agents and prosecutors have the best tools to fight that scourge." They
are not the only ones finding issue with the U.S. domestic terrorist strategy.
Just this year, the U.S. Department of Homeland Security found "major gaps in national terrorism efforts." Blaming a lack of investment and focus.
So, will these latest shootings make a difference and what changes are needed?
Let's get straight into this with Peter Neumann. He's a professor of security studies at the Department of War Studies at Kings College London.
His latest book is called "Bluster: Donald Trump's War on Terror." And he's joining us in the studio.
Welcome back.
You are always with us when we try to figure out how to recognize what we're seeing and how to find solutions. So, let's just start with what the
FBI association has called for, and that is to make domestic terror an actual federal crime. I mean, I was amazed that it's not. What -- is that
the right first move?
PETER NEUMANN, AUTHOR, "BLUSTER: DONALD TRUMP'S WAR ON TERROR": I think it's necessary and it's been called for for years. Especially in the past
few years, there has been a year on year increase in incidents of hate crime, in extremist murders, terrorist plots by far-right extremists.
Really since 2015, these numbers have increased year on year. Yet, the current administration hasn't really done anything about it. It was
absolutely needed that especially the FBI itself is calling for that.
AMANPOUR: What has -- I mean, why hasn't it? Is there sort of a conflict between what you can do against it? I mean, some people say it's freedom
of speech or freedom of this, that or the other that is online, that you can't sort of crack down on these.
NEUMANN: I think it's certainly harder in the United States than, for example, in the U.K. because of the First Amendment, because free speech is
so absolute. So, whereas the British government can crack down on websites and can arrest people for racial incitement. Those laws do not exist and
they will never exist in the United States.
However, there's also a politicalists. When the Trump administration came in, they had the attitude that being worried about White nationalism is a
bit of a liberalist -- it's a bit of an Obama issue. The real enemy is radical Islam. And so, a lot of efforts were shifted in that direction and
programs that dealt with right-wing extremism were, in fact, shot down.
AMANPOUR: So, let's just take that because radical Islam, for a long time, was and certainly in other places remains a problem. But it's shifted in
the U.S. They're not coming from abroad to infiltrate the U.S. They're sort of radicalizing or they were inside the United States. Massacres done
in the name of Islam. But now, even that shifted to this White nationalism, this White supremacy.
So, how much of a heavy lift is it to move law enforcement and statutes and all the political and security efforts that need to take place?
NEUMANN: I think it's less difficult than it seems. At the FBI, for example, at DHS, the Department of Homeland Security, there are people who
have been working on these issues for years. Except in the past few years, they've been sidelined. I think they need to be brought up again. They
need to be promoted again.
People have to be told, "You can make a career. You can get a promotion by looking after White [13:05:00] nationalists." That's not been the case for
the past few years. It was not a priority. By making it a priority again, you can, I think, recycle some of these energies that have been lost in the
past.
AMANPOUR: So, we heard President Trump categorically denounce monster, the White supremacy, racism, terrorism, he used all of those words in one
sentence, and then he added mental health issues, red flags, video games, death penalty. I want to play this soundbite. It's one of his solutions
for this crime.
(BEGIN VIDEO CLIP)
TRUMP: Today I'm also directing the Department of Justice to propose legislation, ensuring that those who commit hate crimes and mass murders
face the death penalty and that this capital punishment be delivered quickly, decisively and without years of needless delay.
(END VIDEO CLIP)
AMANPOUR: So, is that a solution?
NEUMANN: I don't think it necessarily is. It depends what you think about the death penalty. I think it would be much more important, in fact, to
change the rhetoric. Because it's very clear that part of this increase over the past few years has been because of a political climate, polarized,
paranoid political climate which has enabled some of these very ugly actions that we've seen.
If someone constantly speaks about invasion, if someone speaks about an existential threat to the nation coming from immigrants, you shouldn't be
surprised that some people conclude that it's now time to take matters into their own hands. I think that's the issue, not necessarily any particular
law.
AMANPOUR: So, the El Paso killer did post online on this 8chan extremist site, which now has been closed down, that it was about the invasion by
Hispanics.
NEUMANN: Exactly.
AMANPOUR: The Hispanic invasion of the United States. So, we know that President Trump has used all sorts of words like that infestation/invasion.
And his people will, obviously, deflect any criticism that this tone is set from the top. But the "New York Times" is reporting today that the Trump
campaign has been using Facebook ads to amplify invasion claims.
Since January, the re-election campaign, according to the "Times" has posted more than 2,000 ads on Facebook that include the word "invasion" as
part of a barrage of advertising. And it's very different than the terminology of the 2016. It looks like up until now, they have taken that
word as a wedge issue for an election campaign. Now, they'll deny it. But do you think that this will stop?
NEUMANN: I don't think it can stop. I think that the political brand of Donald Trump very much relies on White outrage. And we've seen in 2016 but
also in 2018 and I predict we will see in 2020 that he will ramp up that rhetoric whenever it comes to the election day because he knows that
mobilizes his base.
Steve Bannon, his former assistant, he once said, "Anger is what people -- what gets people to the polls." And that's how he ran the 2016 campaign,
that's how he won it and that is, unfortunately, how he's planning to win it again. And that's why whatever he says in the White House, whatever he
reads from a pre-prepared statement is one thing. The other thing is to see what he will say at the next mega rally when he speaks to his base.
AMANPOUR: Well, obviously, we've got to really watch all this and hold him to his own words now.
NEUMANN: Absolutely.
AMANPOUR: The words that he spoke from the White House in the aftermath of this tragedy. I don't know what to call it. It's obviously a tragedy but
it's a mass murder, as well. And I think too many people just look at the victims, which is obvious, we have to mourn them, but don't look at the
politics.
If this had been an Islamic terrorist posting a manifesto on the website, all hell would have broken loose in the United States. Massive resources
would have been committed to that. But because it was this, suddenly we were told, "Oh, it's too soon to talk about the politics." You can't talk
about guns. You can't talk about, you know, national security or domestic terrorism means. The politics, surely, has to change, as well, around
this.
NEUMANN: Yes. And I think one of the key corner stones of the politics for the past few years have been to portray terrorism and counterterrorism
as an immigration issue, as something that comes from outside in. That is why we have to close down borders, that's why we have to keep Muslims out,
that's why we have to build a wall to Mexico because ISIS is coming through Mexico into the country.
And I think, people now need to understand this not necessarily an issue that comes from the outside in, it is an issue that already exists within
American society and it requires different tools [13:10:00] from the ones that Donald Trump advocates in 2016.
AMANPOUR: All right. Peter Neuman, we'll continue to watch this. Thank you very much indeed.
NEUMANN: Thank you.
AMANPOUR: So, amid all of this tragedy and the search for solutions, there's also a broader more global threat, one we thought had been laid to
rest, and that's a nuclear arms race, nuclear warfare even. Are we actually facing less rather than more constraints around these weapons?
There are worrying moves like Washington's withdrawal and Moscow's suspension of the INF Treaty. That's a pact between the two nations which
was made at the height of the Cold War. It banned a class of mid-range nuclear missiles.
Meantime, right now, in South Asia, Kashmir is becoming a flash point between two nuclear neighbors, Pakistan and India, after India revoked
Kashmir special status. All the while, tensions persist with nuclear North Korea and so far, nonnuclear Iran.
Ernest Moniz is CEO of the Nuclear Threat Initiative. He was U.S. energy secretary during the Iran nuclear negotiations. And in a recent piece, he
coauthored in "Foreign Policy" magazine Moniz finds a way that Washington and Moscow can stop a new nuclear arm race.
Secretary Moniz, thank you very much for joining me.
ERNEST MONIZ, FORMER U.S. ENERGY SECRETARY: Thank you, Christiane.
AMANPOUR: So, I mean, look, we're talking to you about the worst and most deadly of weapons in the -- you know, in the aftermath of a terrible common
or garden ordinary weapon that killed masses and masses of people. And some people might say, you know, "Are we being a little too esoteric? Are
we reaching a little too far into the stratosphere?" This sphere that you're pointing out right now. Are we in the midst of inching closer to an
accidental war with nuclear weapons?
MONIZ: Well, we, unfortunately, think that, frankly, the U.S. and Russia, in particular, if you like sleepwalking into a situation of strategic
instability which, of course, is what we worked so hard against during the height of the Cold War.
There are many issues. You've touched on some such as the breakdown of the arms control architecture. Frankly, it looks like after 2021, we may, for
the first time, have no constraints whatsoever on our nuclear weapons. We are seeing new technologies that have not been addressed like cyber risks,
like the new hypersonic vehicles which could travel a mile a second. We are seeing a lack of discourse between the United States and Russia.
Frankly, not taking our responsibilities of having more than 90 percent of the world's weapons and recognizing this existential threat and therefore,
our associate responsibility. We've never had such a drop-in dialogue. We can understand the political issues here, of course, Russian interference
in the elections, Crimea and Ukraine and other issues, but we cannot have a lack of communication, military to military communication, crisis
management that will not allow, hopefully, a miscalculation to escalate into an actual use of a nuclear weapon.
AMANPOUR: So, what do you lay out in your article? I mean, you've looked for ways to rein all of this danger and threat that you've just outlined,
rein it back. What are the -- I suppose the pragmatic, immediate steps that need to be taken to reverse this?
MONIZ: Well, for one thing, we say that, and this may sound counterintuitive, but we think that we need to start at home with much
stronger dialogue and process building between the United States Congress and the administration.
If that happens, it can provide a more political space to get back to the professional discussions among diplomats, among military that provides at
least more stability in times of a crisis to prevent escalation. Then, of course, we need to have those discussions between the two sides. We have
to stop treaty discussions with Russia as though somehow, it's a gift as opposed to a responsibility when we have, again, the world's major arsenal.
We need to start getting into discussions. In which there was some promise after the first Trump-Putin summit. But unfortunately, not realized in
terms of providing the guardrails, the guidelines, the norms on cyber issues in our command and control systems. For example, we should be
talking about not having a new arms race [13:15:00] rebuilt in Europe, on either of the Western or Russian side because that's what the INF Treaty
was stopping. The INF treaty is no more.
So, there's just a whole list of issues that we can do that are pragmatic and we have to be cleareyed and understanding that we have many, many very
significant political differences with Russia and geopolitical differences with Russia. But that cannot deflect from having the kind of discussion on
existential issues that we are responsible for.
AMANPOUR: I mean, Secretary Moniz, you talk about political issues, well, I mean, there couldn't have been worse political issues than during the
height of the Cold War between then USSR and the USA. And yet, there were -- there was a framework of arms control and treaties that kept, at least
some controls and constraints and mutually assured destruction and all of that. It seems to be strange that suddenly the politics today are deemed
even worse than they were back then.
But I wonder whether you could -- I mean, given this, between these two -- you know, the major nuclear powers, the U.S. and Russia now, when you see
what is happening in Kashmir, what is your fear? Do you think that that is something that can, you know, stumble into an accidental situation? These
two countries, India and Pakistan, have gone to war three times over Kashmir and now they're both nuclear armed.
MONIZ: In fact, first, let me comment on your statement about the Cold War. It's right on. And so, just to be explicit, I mean, Ronald Reagan
and Gorbachev did not say, "Let's stop talking about nuclear weapons because we have so many other differences around the world," it was exactly
the opposite, as you pointed out, and that's what we need to get back to.
With India and Pakistan, it is clearly one of the most volatile potential flash points we have for two nuclear armed states, and they've gone to war
over India -- over Kashmir, as you say. And, of course, we had, just six months ago, a situation that easily could have gotten out of control. And
I think what it points out, as well, is that in this case probably, the U.S. and China would be the two countries that need to work together to
kind of tamp down the instability over Kashmir, frankly, given the provocative act that India has just taken.
But that's where -- whether it's with Russia, with China, with our NATO allies, unfortunately, we are not seeing the kinds of relationship building
that could help us work together to solve these hard problems. We mentioned Russia but, obviously, with China, as well, we have a very
difficult political issues that are not really based on nuclear weapons but make it harder for us to get the kind of stability and the kind of problem
solving that we need to have from these leadership countries.
AMANPOUR: So, right now, there are two other hotspots, the nuclear armed North Korea has been test firing short-range missiles, maybe medium-range
because they're angry at South Korea and the United States upcoming military exercises. And President Trump seems not to be too worried about
that. He says, "These are not the threats that we had got the moratorium on and I'm confident things are going to be OK."
Whereas with Iran, which you were intimately involved in this nuclear deal and securing the nuclear deal, and we've talked about it before, they've
pulled out and who knows what might happen accidentally in the Persian Gulf with the ratcheting up of tensions.
I just want to know from your perspective. You met with Foreign Minister Zarif a lot, along with Secretary Kerry. What is your view of sanctioning
a diplomat in this -- you've just talked about the need for channels and communication and diplomacy and frameworks.
MONIZ: I think the sanctioning of the foreign minister is one of the most mysterious acts, in my view, that we've had in this whole saga. Because,
in fact, the president keeps talking about wanting dialogue, in fact, wanting dialogue with no preconditions. That's hard to do without having
the primary interlocutor sanctions.
In fact, there's a parallel, I think [13:20:00], with North Korea and, actually, with Russia, as well, in the sense that the president seems to
want everything to be personal diplomacy at the leadership level. And I think that can be very important, for example, with North Korea in opening
up a dialogue. But then one has to get into a very serious professional and drill down negotiations as we did in 2015 with Iran leading, in fact,
to a very comprehensive agreement.
With Iran, now, if we lose that agreement completely and, obviously, the United States is out of it and it's perhaps hanging on by a thread with the
Europeans and Russia and China, if we lose that, we will have lost not only the direct constraints on Iran's nuclear program, but I would say even more
importantly the long-term ability to have extraordinary inspection rights, transparency, verification rights. You know, if we lose that, it can be a
slippery slope in terms of losing much of the access that we need for making sure there's no covert activity that could lead to a resumption of
Iran's nuclear program.
AMANPOUR: All right. Secretary Moniz, thank you very much indeed for joining us. And of course, you've got this article in "Foreign Policy" on
ways in which to rein back this potential nuclear arms race. Thank you so much.
Now, we focus on a nonmilitary war fought all around us online where disinformation is being used as a weapon to undermine the world's
democracies. And for more on this, I'm joined by journalist and author, Peter Pomerantsev.
Almost a decade after working for Russian television, he revealed how Russia manipulates the truth to try and control the population. Now, in
his new book "This Is Not Propaganda: Adventures in the War Against Reality," he's turned his gaze on the age of disinformation. And he's
joining me here in the studio.
Welcome. Welcome to the program.
I mean, it seems like a good time to be talking to you about all of this given what we're seeing, the real threats of a new arms race, the real
threats of online, well, incitement and violence and real death and killing that is being sort of manifested online and in reality.
So, let's -- can we talk about the aftermath of what happened in the United States? You yourself have interviewed those kinds of people, those kind of
right-wing radicals, White supremacists in Europe, right?
PETER POMERANTSEV, AUTHOR, "THIS IS NOT PROPAGANDA": Yes. They tend to avoid the term White supremacist. They're more cunning these days.
Actually, I interviewed the leader of the Identitarian Movement whose ideas were invoked in this sort of gruesome manifesto of the shooter.
And, you know, it's quite weird. He sorts of uses the language of pro- democracy movements. He says that it is, you know, the White Europeans who are now suffering under the yolk of terrible multiculturalism.
These people use ideas like that they have to preserve ethnic diversity, which is a way of saying they have to -- you know, they want to stop
intermarriage. So, they keep on using the language of progressive causes, of democratic causes, in order to, you know, have an excuse to impose very
authoritarian ideas.
And I remember, and I'm quoting not quite exactly now, the leader of the Identitarians telling me, "You're still fighting the old far-right. We're
the new far-right and we're much, much cleverer."
AMANPOUR: So, let's quickly touch on that before I get to the heart of your book. You heard me talk to Peter Neumann, the counterterrorism
specialist about solutions, and the U.S. desperately trying to figure out solutions and the FBI calling for a statute that would create, you know, a
crime out of this domestic terrorism. So, what are they saying? What is fighting the old far-right? How does one fight the new far-right?
POMERANTSEV: Well, first, one does have to pay attention to language, one does have to be careful the way language is being kind of reformed in order
to legitimize very, very harmful ideas. And by harmful, I mean, that they -- it is their ideas that kind of delegitimize the rights of others.
The word nationalism is making a comeback. It was often a taboo word and it was in Trump's speech where he made a big deal of saying, "Hey, it's OK
to say nationalism." Look, in it of itself, the word is whatever it is but what are the values that are being imported with it? So, we do have to
watch language and I think we need organizations that are constantly engaging the audiences that are vulnerable to these messages.
AMANPOUR: Now, beyond the sort of national security and counterterror aspects, there's also, as you talk about, trying to counter the language
and the message that are being spread online. Some countries try to restrict it. But you don't like that.
[13:25:00] You think it's possibly just another road down censorship, in which you know very well from your years and your father's years in the
Soviet Union. How do you control, if you don't take off the hate speech and the violence and all the rest of it?
POMERANTSEV: Well, listen, hate speech, there are different definitions in different countries, as Peter was saying. So, in Britain or in Germany,
there would be no problem working with the existing laws to take down a lot of, you know, far-right speech. America has its own unique tradition and
the First Amendment is a sacrosanct.
But look, even -- a lot of the speech, even before it gets into sort of incitements of violence and the really, really kind of angry, vicious
threats you hear, it's very, very hard to sensor it. It is actually just political speech. And do we want to go down a road of censoring political
speech?
So, I think there's two things that need to be done. One is to compete with this. So, that means I think a type of civil society organization
that reaches to these audiences that are vulnerable to these messages and tries to talk to them and tries to talk them down and engages with them at
a much earlier stage in the violence.
I do think we need regulation but the regulation shouldn't be to sensor. The regulation should be to give us more information. Because at the
moment, you know, when we look at the online world, we don't know if something is a bot, a troll. We don't know if it's organic or inorganic.
Actually, we're kind of surrounded by an information environment where the reality of it is censored.
Now, there's ever a good law that's come out in California, I think it's a good law, which basically says that if something is a bot, automated
account on online, it has to say "I am a bot," you know, so you know that a campaign is a campaign. It's a normal person, this is a campaign. I think
taking that kind of coordinated and authentic behavior and showing where it's happening would empower people. And that's a way of regulation that
gives us more information, not censorship.
AMANPOUR: And now, which seems obvious, we should know the sources, we should know, you know, who is talking to us. What did you learn at Russian
television?
POMERANTSEV: It was very funny. So, I was in Russia from 2000 through 2010. And just to be clear, I worked in entertainment television, which is
actually a more subtle form of propaganda, in a way. But already I saw things happening in Russia which, at the time, I thought it was specific to
Russia. Sort of a politics that based around nostalgia, where there were no ideologies anymore and just feelings, this idea of raising Russia off
its knees or make Russia great again.
And just kind of attitude of facts and political discourse and from politicians which didn't try to convince people, but kind of said, "We
don't care about facts. Actually, it's a release. Hey, facts, who needs them?" And it's a very performative approach to politics. And I could
have left Russia sort of feeling that this was unhealthy and I wanted to go back to the West which had values and debates and rationality. And 10
years later, my book is partly about this, I see this same kind of pathologies in public opinion and in propaganda emerging here.
AMANPOUR: I mean, there are two bits to that, the whole business of you learning in Russia that who cares about facts. I mean, we heard during the
Brexit campaign people are fed up of experts. We hear in the United States that experts and evidence are called hoaxes and all the rest of it. So,
that is something that is very profound and very dug into our societies right now.
And then you talk about debate and information and deliberation. Well, I just want to quote from your book, you know, you said, "More information
was supposed to mean a more informed debate. But we seem less capable of deliberation than ever.
More information was supposed to be mutual understanding across borders but has also made possible new and more subtle forms of subversion." In other
words, this tool which is meant to give us so much has actually sort of harmed debate and deliberation.
POMERANTSEV: It's not the tool itself, it's the way it's been exploited by sudden forces. I mean, so, I talk about my parents in the book who were
Soviet dissidents. And for them, everything was a battle to get information, to express themselves, censorship was the way authoritarian
regimes worked. We've kind of forgotten about that world.
But 30 years after sort the fall of the Berlin Wall, it's worth remembering how -- you know, how little information it was, how scarce it was. Now, we
have the opposite.
You know, the flood gates have opened who have information abundance but very similar forces to the ones who arrested people like my parents in the
1970s have now gone, "OK. We can't censor information. What we're going to do, we're going to flood it with so much disinformation people don't
know whether they're coming or going."
And in that chaos, paradoxically, you often look to strong leaders because you feel insecure, you don't know where your orientation is. So, actually,
the strongmen have returned with flooding us with disinformation rather than constricting it.
AMANPOUR: You coin this term postmodern dictatorship for Putin's Russia.
[13:30:00] I don't know whether you like that or not, but that's -- you coined it. Does that fit into what you're talking about right now in terms
of manipulating the information?
POMERANTSEV: Completely, in the sense like when we talk about postmodernism. What we mean is there's no one single message. There's not
one single ideology.
You know, the Putin regime, Boris Johnson, you know, current president of the U.S., they kind of chop and change their messages, you know, depending
on what they need in that one moment. But, also, postmodernism is about the creation of simulacrum, so many fakes. You don't know what reality is
anymore.
Literature is about that and now we have a politics where there's so many replicas and fakes out there, that we can't find our way back to reality.
AMANPOUR: So now let's drag ourselves back into the real world. There's been a real mass shooting. Yet another one in the United States.
The one we've been talking about, obviously, and there's a search for solutions. If it's impossible to have real debate and deliberation over
these big issues, the solutions and the politics around whether it's counterterrorism or whether it's gun control or whatever it might be, how
does that happen?
How do you see this developing now as this is going to be, hopefully, if it still has legs by September when Congress comes back, a big issue that
needs to be dealt with?
POMERANTSEV: Whose job is it to do that? I mean, in a way, I think public service spirited media. So the BBC in media and maybe even CNN in America
or certainly PBS, it's part of their job and I've worked with organizations like that. It's part of our job to do that.
But that really means opening a new leaf, I think, really, really understanding prioritization. Not just saying we have a lot of stupid but
actually understanding what drives them in a non-patronizing way and really trying to engage them.
Actually, the tools that propagandists use to spread this information targeting base for analysis, they can be used for good. We could be
understanding more about audiences and then dragging them into a common debate.
But someone has to do that. And let's be very honest, so far a lot of media make money from polarization.
Trump does one thing. We play the other. We try to get our base up. He gets his base up.
We're locked in this polarization spiral. Let's be honest, the ad revenue depends on that. Not just because it's a spectacle but especially online
and tech, you get more likes and shares if you play to confirmation bias if you feel polarization.
So that hasn't broken. Someone has to say I'm not going to make money out of this.
And someone has to say this is a public good that we're going to do. I really hope public service broadcasting can evolve to this new challenge.
AMANPOUR: Well, here we are on PBS and it is a huge new challenge. And let's just talk about one thing, which is not in the terrorism and white
nationalist sphere but in the sort of right and again language and activities that we thought had been won and now seem to be raising.
We thought, for instance, misogyny was dead a while ago. We thought all sorts of things had been conquered but now it comes back with this huge
sort of waves of assault online. Tell me about that.
POMERANTSEV: It's one of the great paradoxes because we always thought of the incident when it appeared as a kind of progressive thing. But it's
brought back all this residual anger and misogyny.
I was in the Philippines for my book. I actually go around the world. I went to Mexico, to the Philippines. I try to see the world beyond Russia
and America and England, which is what I know best.
And, you know, there is a disproportionate amount of abuse that the female politicians get, that female journalists get, and the female activists get.
And I talked to them, why do you think this is happening? And they thought it's just below the surface.
It had been kind of tamed to the point where it was impolite to do this in society. But the internet has allowed all this anger and all this residual
stuff to float up unchecked.
Yes, it was shocking. It was shocking to the journalists I spoke to. This is in the Philippines. But in Mexico, it's maybe even more vicious.
AMANPOUR: And with a country like the Philippines gets all this news from Facebook, I mean that's where they get their news from, what does it mean
to the public discourse and the political dialogue?
POMERANTSEV: Well, it means that, A, a certain type of propaganda prevails which is the social media kind of -- social media style of propaganda that
we've always had propaganda.
But when a T.V. channel that you know is owned by someone is spouting something at you, you can kind of like make a judgment call about what is
going on.
When you're completely dependent on Facebook when you don't understand that what looks like normal people saying that individual thoughts are actually
coordinated campaigns that have crept inside your feed, the propagandas are so much insidious. It's so much harder for you to take a critical position
to it.
That's the first thing. The second thing is, who is then responsible to regulate it? Is it then up to Facebook to say OK, we're not just a
company, we have a social [13:35:00] responsibility, it's our job too?
Or do we need, you know, much more law that says, OK, Facebook, these are the rules of the game, this is what you have to regulate. And if you
don't, you'll get sanctioned as the British are about to introduce.
There is really a question of responsibility. Because for broadcasting, we had regulators.
They were maybe corrupt. They were faulty but they existed. For Facebook, whose job is it?
AMANPOUR: Well, we'll be grappling for a long time. Thanks for helping us. Peter Pomerantsev, thank you very much indeed.
Now, in our darkest times, it can be difficult to find hope whether personally or through a loved one. Most of us have experienced cancer.
The good news, though, is that significant numbers survive the disease today. And our next guest, Dr. Siddhartha Mukherjee, is a Pulitzer-Prize
winning author and an oncologist.
He joined our Walter Isaacson to discuss the complicated landscape of cancer care.
WALTER ISAACSON, CNN CEO: Sid, welcome to the show.
SIDDHARTHA MUKHERJEE, ONCOLOGIST: Thank you for having me.
ISAACSON: You have a great piece in the "New Yorker" and a more scientific piece in the proceedings of the National Academy of Science recently
talking about modifying our white blood cells, our immune system so that they can hunt down cancer more correctly. Is this a big new way of looking
at cancer?
MUKHERJEE: It's a profound new way of looking at cancer. And the basis for this really dates back almost a century.
So the centerpiece of all this is that for a long time, we've been focused on the cancer cell. What is wrong with the cancer cell? What genes are
wrong with the cancer cell? Why does the cancer cell proliferate? Why does it divide? Et cetera. Et cetera.
But over a century ago, a second group of scientists, a group of researchers, a group of doctors began to wonder why not just worry about
the cancer cell, what about also worry about the environment, the home that the cancer cell is --
ISAACSON: In other words about the patient, the person.
MUKHERJEE: The person, but, in fact, the tissue of the person because cancer -- what is interesting about cancer, I mean there's some very basic
questions.
Why do some cancers only metastasize to some organs and not to other organs? Why does the breast cancer or lung cancer have a propensity to go
to the bone?
Why does myeloma, which could live anywhere love to live inside the bone and the bone marrow? Why does leukemia live in the bone and the bone
marrow?
So there are reasons and the reason has to do with interactions between the cancer and its microenvironment. The tissue or the home that the cancer
builds around itself.
ISAACSON: So what you're saying is you take our own immune system.
MUKHERJEE: That's right.
ISAACSON: It's called immunotherapy sometimes but now it's going beyond that because your gene adapting our immune system to actually hunt down the
exact right cancer.
MUKHERJEE: Exactly. So our work and other people's work involves using gene editing to change the microenvironment of the host. Either to
activate the immune system and thereby kill the cancer, or to change the immune system of the host or the blood system of the host such as the
cancer becomes visible to the immune system.
So all of these fall under a large family of ideas, which has to do with use whatever technology, gene editing, anti-bodies, et cetera but
concentrate not just on the cancer cell but on the home that it builds around itself, on the tissues that it occupies, and ask the question what
is it about the host? What is it about the patient that is allowing the cancer to flourish?
ISAACSON: You just talked about gene editing. And there are really two types of gene editing.
Those that edit early stage, embryo, so it's an inherited change in the gene and those that just try to do it in the body of the patient and a
particular tissue. Which ones are you using now?
MUKHERJEE: So we are using exclusively gene editing in cells that will never be transmitted to the next generation.
ISAACSON: So it's safer?
MUKHERJEE: So it's -- well, not only it's safer. It's actually ethically permissible.
We're working on an international framework to figure out whether or not to and to what extent to make changes in sperm and egg cells and in embryos.
It's called germline cells, cells that will transmit the information not just into you but into generations to come.
ISAACSON: You say that's ethically problematic. Why is it ethically problematic to change our genes so that our children will be healthier?
MUKHERJEE: Well, the question is -- that is really the biggest question. Can you change genes? Under what circumstances can you change genes so
that your children will be healthier?
Well, one idea which has become very clear is that there has to be a disease of extraordinary suffering involved. But these arguments are going
on right now.
There are other ways you can decide to treat some children. So there are other alternatives.
The question of extraordinary suffering is very important. And perhaps the most important is that we don't know all the side effects of changing genes
in the germline.
[13:40:00] We don't know exactly how accurate it is. It seems to be pretty accurate and pretty safe, but we need a lot of experiments. We need
a kind of international agreement to figure out whether this is going to be permissible or not permissible and what should be in next case.
ISAACSON: In China, you have one doctor doing it last November.
MUKHERJEE: That's right.
ISAACSON: In Russia right now --
MUKHERJEE: Correct.
ISAACSON: -- you have a doctor about to do three different cases, just to cure congenital deafness in the germline. Why are you talking about
creating this whole consensus when doctors are just going to go ahead and do it in some places?
MUKHERJEE: Well, doctors are not going to do it in some places. They would do it in ways that are not technically safe often and that will set
back the field.
I'll remind you of what happened with gene therapy. So in the 1990s, there was an attempt to do a gene therapy on a young boy named Jesse Gelsinger.
ISAACSON: Yes, in Philadelphia.
MUKHERJEE: In Philadelphia, right. So this seemed -- the experiment seemed relatively technically feasible. It was moved through various
boards and authorities to make sure that it was safe.
In fact, what turned out was that the child died as a consequence of gene therapy. But it set the whole field back by about 10 years.
ISAACSON: You say it should only be used in cases of extraordinary suffering. Meaning editing of our genes from our children and children's
children.
Why? Why not do it so that you could be taller or blond or whatever you might want to be, blue-eyed?
MUKHERJEE: I think the question of enhancement, first of all, it's not technically easy. It's a vast technical problem. People underestimate it.
It's not if I can insert or take a gene away or edit a gene to allow you to grow wings or even enhance your height. We now know for most normal human
beings, height is controlled probably by a hundred-odd gene or maybe more, thousands of genes.
Our most complicated -- complex features we have, skin color and height and other things, are controlled by hundreds if not thousands of genes. We
don't have the technology to edit thousands of genes at a time.
But leave aside the technical question that the specter of handing this technology to potentially people who are wealthy and powerful and leaving
behind people who are not wealthy and powerful and cannot afford or access these technologies creates the possibility of a genetic rift in society,
which I think most reasonable people would think is it divides human beings rather than unites human beings.
And I think that's where a lot of the ethical conundrums come, too. Do we really want to genetically divide the society?
That's a big deal. That's a human species altering itself. That's the prospect of -- as John Sulston, the biologist said, that's where the
machine begins to change its own manual.
We, I think, are not ready to be the machine that changes its own manual. We're not ethically ready. We're not technically ready.
We're not scientifically ready. We're not prepared as a culture, as a -- if it's the right word to use, as a species. We're not ready to start
changing our own manual.
ISAACSON: You're an expert in blood cancers.
MUKHERJEE: Uh-huh.
ISAACSON: Suppose we knew that a child had a predisposition to leukemia --
MUKHERJEE: Yes.
ISAACSON: -- some form of leukemia. What do you do?
MUKHERJEE: Well, we are now beginning to understand what to do with someone with such a predisposition. We are now finally beginning to figure
out how to monitor them. And whether that monitoring actually will end up saving their lives.
So there are many, many children where we now know that there are genes that will predispose them to leukemia. We've identified some of these
genes.
It's not an easy answer because you don't want to over-treat patients before they have the disease. There's clearly an environmental and a
chance component to the disease so you don't want to treat a person who doesn't have a disease.
But you also don't want to ignore the fact that they have a propensity, which is increasing, perhaps every year to have the disease. So now there
are -- now that we have those information, there are, I would tell you literally, tens and dozens, perhaps hundreds of clinical studies trying to
figure out exactly what to do with people with the predispositions for the disease but you don't have the disease itself.
ISAACSON: If you saw somebody with a predisposition to such a disease, could you genetically engineer, say, the bone marrow in that body? Take it
out of the body, genetically engineer it, reinsert it back in so it would be less likely to get a cancer?
MUKHERJEE: In principle, you can do that. Especially if it's a single gene.
In principle, you can do absolutely that. Again, it can be technically challenging.
It depends on the exact gene. It depends on whether it will be amenable to doing things like editing or not. But [13:45:00] in principle, you could
do exactly that.
You could -- and especially for blood diseases. Blood diseases are important because they have this unique capacity, which is not true for
most diseases that you can take the bone marrow out, you can then re- engineer it in the laboratory, and then insert it back in.
I'll give you some examples of what is happening in this area. Take a disease like sickle cell anemia. So not a leukemia but a terrifying form
of anemia.
We now have technologies to take blood from an individual, take it out, modify them genetically, either introduce the correct gene or correct the
gene that's already a problem, and then put it back into a patient's body.
These trials are ongoing. It will be -- there's no doubt in my mind whatsoever that in the next 10 years this will be the practice for disease
like sickle cell anemia. Again, single gene-disease.
ISAACSON: You talk about gene therapies that are done in the body like changing the bone marrow, our immune system, or white blood cells. And you
speak of it as a drug.
Yet these treatments now cost more than a million dollars. Are you worried that these will bankrupt our entire health system? Or how do we even
approve them as "drugs" when they're not like drugs where you just manufacture it in New Jersey and package it up and a people buy it at the
pharmacy?
MUKHERJEE: That's right. So this is a conundrum and it's the center of the conundrum of this piece that I just wrote in "The New Yorker."
So we used to be able, in the past, to be able to divide the world of medicine into procedures and drugs. What is amazing about these cellular
therapies, including genetic therapies, is that they live in between. They're in this in-between land.
On one hand, they're procedures because you have to take cells out of the body, manipulate them in the laboratory, grow them up, and then inject them
back into the body. And it requires a lot of artisanal work, a lot of manual work, handwork, quality control. So the blurring of these
boundaries is happening right now.
The problem, one of the central conundrums, is that these procedures, drugs, these drugs/procedures, costs around $400,000 if you take in all the
hospital costs involved. The fact that you would be in the hospital, you have complications, et cetera, et cetera.
And if we were to start having these -- and some of them are curative. So if we were to start using them, it would soon start amounting to several
billion dollars.
And it's hard to say that they're useless because they're not. They're useful things we're doing. We're actually helping patients.
So the conundrum of how to price these properly, how to understand these properly, and how to bill for them properly without bankrupting Medicare is
a huge conundrum.
ISAACSON: So you have cured people of cancer but some of these procedures, $400,000 up to a million dollars, right?
MUKHERJEE: Yes.
ISAACSON: So who gets it? Only people who can afford it?
MUKHERJEE: Absolutely. I mean, you have to have -- first of all, the person who is paying is ultimately insurance, if you are insured. But as
you know, many many people in this country are not insured. So you won't even have access to these medicines.
ISAACSON: What about Medicaid/Medicare? Should they cover it?
MUKHERJEE: Again, if it's useful, then it's valuable. Medicare and Medicaid should cover it.
ISAACSON: So how long would it take to bankrupt Medicaid and Medicare if you did it?
MUKHERJEE: It depends on how many of such drugs there are. Right now, most of these are for rare diseases but they're actually rapidly moving.
ISAACSON: Leukemia, which is not all that rare.
MUKHERJEE: So the work that we do has to do with leukemia. It's actually not that rare.
In fact, there's a pre-leukemia condition, before you have leukemia which we're now attempting to do and it's just as lethal by the way, very lethal
condition.
We're trying to use that. So that would already expand the number of patients to about 20 or 30,000 patients a year.
ISAACSON: OK, I can't do the math real well. But let's say it's a million dollars and there's 30,000 patients.
MUKHERJEE: That would be a big, big blow.
ISAACSON: No, it would totally just end Medicare and Medicaid, if you did that.
MUKHERJEE: That's right. So we have to find a new system. I mean, either we go bankrupt --
ISAACSON: Yes.
MUKHERJEE: -- or we really innovate not just scientifically. The scientific innovation is on a fire hydrant now.
But that said, the manufacturing cost will probably come down at least 5 to 10 fold. That's the prediction for most people.
I work in the field. We are making rapid engineering innovations. It's not the kind of innovation that hits the front page of "The New York
Times."
It's things like how do you automate? How do you use robots? How do you use quality control?
Small [13:50:00] improvements, none of which make the cover of the "New York Times" or Science or Nature Magazine but, in fact, bring the cost down
chip by chip by chip by chip so that you can get to a point of time when it's affordable.
ISAACSON: When you say "we", that we're bringing the press in, you're partly talking about yourself not only as a scientist but as somebody who
has started drug companies, pharmaceutical companies yourself and you're making money.
When you write about this, when you write in "The New Yorker" about it, when you propose this, how do you resolve sort of the conflict of interest
in a way between you having a drug company trying to do it and you trying to advocate that the FDA do different rules?
MUKHERJEE: So in my case, the companies emerged under the laboratory but they're not drug companies yet. These are companies that are not selling
any medicines. We're making medicines. We're in early clinical trials.
We -- so one of them is called Vor Biopharma. There's another one called Fayette.
These are not selling drugs. The minute these companies sell drugs to human beings, the conflicts of interest lines go up very strongly.
These are not publicly traded companies. They're companies that are completely privately -- actually they're running partly out of my own labor
and money.
So there are strong distinctions between conflicts of interest that happen when you are no longer an inventor but the seller of something. I'm an
inventor.
So I explicitly declare it in a piece like this. In a piece like this, I will tell people, you know, I'm doing this myself. I'm in the middle of
doing this myself.
And in the world of science, writing about things that you're doing yourself, even if that has commercial value, is not a conflict of interest.
The minute that drug becomes a pharmaceutical product, it's going out into people and is being priced and charged, it becomes a conflict and that's
when a barrier will come up. And never again will that piece be written.
ISAACSON: So gene therapy, genetic editing, cancer research, what gives you the most hope in the next 10-year time frame?
MUKHERJEE: Well, I think what is happening is that these fields, immunotherapy, gene editing, cancer research, cancer epidemiology, and
hopefully, hopefully, hopefully, cancer prevention will come together in ways that some ways that we're predicting but in some ways that we're
anticipating.
Just to give you one example, for breast cancer -- and this is recent data. For breast cancer, we can now begin to predict for people who have familial
breast cancer. People who we know there's a family history of breast cancer, we can predict with a quite high level of accuracy your propensity
to get breast cancer in the future.
And now there are going to be in the next few years, dozens of studies to try to figure out how to stop this person from getting breast cancer. Do
we give them a medicine? Do we monitor them extensively?
Do we take a blood test and try to figure out the minute they get breast cancer? Do we treat them?
So the whole idea of cancer prevention, meeting genetics, meeting early detection becoming a whole, meeting cancer epidemiology becoming a whole,
that's what gives me the most hope that we would create a new -- based on science, we would create a new oncologist of trying to build up this
pyramid again from prevention to early detection to treatment so that fewer people get treatment and less toxic treatment.
Most people get prevented and some people get detected early enough so that we can actually treat the cancer in its earliest possible phases.
ISAACSON: Thanks for giving us hope, Sid.
MUKHERJEE: My pleasure.
ISAACSON: See you later.
MUKHERJEE: See you later.
AMANPOUR: And that is so much needed hope to end our show.
But before we go tonight, we want to pay tribute to a woman who gave hope and inspiration and great literature to countless readers across the world.
The great Author Toni Morrison has died, age 88.
She worked as a book editor for 20 years before she published her first book at age 39. As an author, her sensational novels "Beloved" and "The
Bluest Eye" made her a national treasure.
President Obama awarded her the presidential medal of freedom in 2012. And she was given the Nobel Prize for Literature in 1993, the first African-
American woman from any country to win.
Accepting the Nobel, she told the world "We die. That may be the meaning of life but we do language that may be the measure of our lives."
That's it for now. Remember, you can listen to our podcast at any time. See us online at amanpour.com and follow me on Instagram and Twitter.
Thanks for watching and goodbye from London.
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