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Amanpour
Red State Kansas Says Yes To Preserving Abortion Rights; A High Stakes Visit In Africa Amid A Global Food Crisis; After Hurdles, Much Needed Help For U.S. Veterans Finally Gets Passed; Interview With U.S. Army Veteran Diagnosed With Adult Leukemia Andrew Myatt; Interview With Wounded Warrior Project Government And Community Relations Vice President Jose Ramos; Interview With New York City Department Of Health Commissioner Dr. Ashwin Vasan. Aired 1-2p ET
Aired August 03, 2022 - 13:00:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
(COMMERCIAL BREAK)
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BIANNA GOLODRYGA, CNN ANCHOR: Hello, everyone and welcome to Amanpour. Here's what's coming up.
(BEGIN VIDEOTAPE)
GOLODRYGA (voice-over): Red State Kansas says yes to preserving abortion rights. What the surprising result tells us about what Americans want as
midterms loom. Plus --
LINDA THOMAS-GREENFIELD, U.S. AMBASSADOR TO THE UNITED NATIONS: People are starving. People are suffering. How can I and the U.S. government use our
positions to help Africa address these needs.
GOLODRYGA (voice-over): A high stakes visit in Africa amid a global food crisis. U.S. Ambassador to the U.N. Linda Thomas-Greenfield on her mission.
And --
UNIDENTIFIED MALE: To our veterans who have been exposed to toxic chemicals from burn pits, we have your back finally.
GOLODRYGA (voice-over): After hurdles, much needed help for U.S. veterans finally gets passed. Two former servicemen on how this legislation could
transform millions of lives. Then --
UNIDENTIFIED MALE: It is an extremely painful and unpleasant experience.
GOLODRYGA (voice-over): Monkeypox takes on New York. Our Hari Sreenivasan asks Health Commissioner Ashwin Vasan, why the city is now the epicenter of
the outbreak in the United States.
(END VIDEOTAPE)
GOLODRYGA: Welcome to the program, everyone. I'm Bianna Golodryga in New York, sitting in for Christiane Amanpour. The message sent by Kansas voters
last night was as surprising as it was clear -- keep abortion legal in our state.
By a large margin, traditionally, conservative Kansas rejected an amendment that would have taken away women's rights to abortion. It was the first
time Americans were called to weigh in on the issue since the Supreme Court overturned Roe vs. Wade in June. Now that's despite polls showing broad
public support for abortion rights.
President Joe Biden has now called on Congress to pass a law to restore protections Roe provided. And with midterm elections just three months
away, Americans desire to defend abortion rights could be a potent issue for Democrats.
So let's bring in my first guest, Donna Shalala, she served as Health Secretary under Bill Clinton and she joins me now from Miami, Florida.
Secretary Shalala, thank you so much for joining us today. So, what is your reaction to that surprising referendum out of Kansas, a deep red state and
more than 900,000 people turned out to vote and their message was decisively clear -- keep abortion legal here?
DONNA SHALALA, FORMER U.S. HEALTH AND HUMAN SERVICES SECRETARY: Look, I'm a Midwesterner and commonsense values prevailed in Kansas. The stars aligned
over Kansas. And the opponents of those that were wanted to just end any chance of abortion made big mistakes. They drafted a bill that would have
allowed no exceptions. They frightened people. And the people of Kansas Republicans, Democrats, Independents, made an extra effort to turn out,
there was a 50 percent turnout in voting, that never happens in a primary.
And to send a very clear message that they wanted the right to abortion to be preserved in Kansas, I'm very proud of Kansans who did this. They set a
very clear message across the country. We've known for a long time, that people believe that some protections should be in place for abortion.
Kansas, in the middle of the country, sent a very clear message to the country. And I wouldn't see this just as a Democratic victory. It's a
victory for commonsense.
GOLODRYGA: Yes, it's interesting because pro-choice advocates who were campaigning ahead of this vote yesterday said that they wouldn't have been
able to accomplish what they did, had they not reached out to those of Republicans, Moderate Republicans, Independents, to also raise this issue
as a rallying call. And we clearly saw the results in that turnout. What does that tell you about the future for other states, other red states that
we're watching very closely to see what happened in Kansas last night?
SHALALA: It says to them that they better be very careful on this issue. And, you know, President Trump identified this as a problem for
Republicans. And so, I think people are going to read into this, that those of us that believe we should protect women's rights, that we believe that
this is a human right as well as the right of families to make these very personal decisions, they better be careful.
[13:05:16]
Because well-organized groups, Republicans, Democrats, that it isn't a red or a blue issue. It's an issue about human rights. And it's an issue about
women's rights and family rights.
GOLODRYGA: Let's just read for our viewers what exactly voters voted on yesterday, what this amendment voted on. And I quote it, because Kansans
value both women and children, the Constitution of the State of Kansas does not require government funding of abortion and does not create or secure a
right to abortion. The results as we have said, no 58.8 percent, yes, 41.2 percent.
A resounding victory for those who were not in support of this amendment. But I'm curious for other states, is this now -- the red states who are
looking to ban abortion. Is this something they can learn from in terms of perhaps rephrasing or changing some of the boundaries and phrasing in any
attempt to ban or limit abortion in their states? What can they learn from this? Or do you think that this is a closed case?
SHALALA: No, it's not a closed case. So, there are very few states that have this written into their constitution. And we should note that
difference. But it does tell state legislatures that they better be very careful, because the people of Kansas sent a message to the country that a
working-class state, that commonsense will prevail and that they want to protect the right to abortion.
And, you know, Roe was a compromise. It allowed the states to put certain kind of limitations, and the public supports that. And these other states
better be careful because the voters, not just Democrats, but Republicans and Independents have sent a very clear message with this vote.
GOLODRYGA: And now abortion is legal in Kansas up to 22 weeks in pregnancy. The Biden administration of course using this to their advantage, the
president releasing a second executive order on abortion rights today directing HHS to consider ways to expand coverage for patients traveling
out of state for reproductive health. The Department of Justice announced this week that it is suing Idaho over the state's near total abortion ban
set to take effect August 25th.
Do you think the administration is doing enough to ride the momentum of clearly what they're hearing not only, as you said, from Democratic voters,
but many Republicans out there who believed that the Supreme Court went too far?
SHALALA: Oh, I think the administration is doing a lot and they'll do much more. Look, all of us want abortions to be legal, safe and rare. And
anything we can do on contraception, on women's health will help us make abortions less likely. But the people of Kansas particularly in urban
areas, huge turnouts in urban areas, rural areas underperformed, but the people in rural -- in urban areas who many of whom were Republican women in
the suburbs, sent a very clear message here. We've got to continue with a comprehensive approach to women's health.
And that includes access to contraception for everyone, making sure that it's affordable, so that abortions can be legal and safe and rare. We've --
GOLODRYGA: Yes.
SHALALA: -- already reduced the number of teenagers that are getting pregnant in this country. We have access to Plan B, for example, we have
access to medically induced abortions. This is a very different world than the world that I grew up in, in which illegal abortions were literally
killing women.
GOLODRYGA: It hasn't gotten a notice that you quoted there twice. Now former boss, President Clinton, who referred it and categorized abortion in
his mind as something that should be legal, safe and rare.
Senate Majority Leader Chuck Schumer today in response to last night's vote said that it shows -- it's showing that the winds are blowing in the
Democrats direction ahead of the midterms. Do you think that that is the case? Because it does appear, that consensus does appear that as of now,
Republicans will win the House despite this issue. Do you think that it can trump some of the other factors that seem to be the clouds hanging over
Democrats right now whether it's the economy whether it's President Biden's low approval rating?
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SHALALA: I think it's a mistake to assume that the Republicans are going to win the House. Even though you see some of the districts that are toss up
districts. This issue tends towards Democrats who support abortion rights. And I think the Kansans and basically said to the Republican Party, stay
out of our bedrooms.
And Republicans are going to vote for Democrats, when they see extreme people in their party that won't even allow abortions in cases of rape or
incest or the life of the mother. There are a lot of bottom lines here. And I have great faith in commonsense voters who come out and say we're not
interested in the extremes. We're interested in protecting women's health.
GOLODRYGA: Secretary Shalala, always great to see you. Thank you so much for joining us. We appreciate it.
SHALALA: You're welcome.
And another big issue in the upcoming elections, rising food prices in the wake of Russia's war on Ukraine. The first shipment of grain since the
early days of the invasion left the embattled country on Monday, bringing hope of relief and countries facing acute food shortages, notably those in
Africa.
U.S. Ambassador to the United Nations, Linda Thomas-Greenfield will tour the continent this week. And ahead of her visit, I asked the Ambassador
what the U.S. is doing to help.
(BEGIN VIDEO CLIP)
GOLODRYGA: Ambassador, thank you so much for joining us. You're about to embark on a trip to Uganda and Ghana this week to discuss the impact of
Russia's war on Ukraine specifically the impact it's having on global food insecurity. Why specifically now, is it important for you to take this
trip?
THOMAS-GREENFIELD: And I will tell you that this trip has been in the planning for some time. So I will, as you noted, be traveling to Uganda and
Ghana, and I'm also doing a breast stop in Cabo Verde, as well. And I have three major aims for this trip. You know, one, I want to affirm and
strengthen the U.S. partnership with these three countries.
I want to discuss the disproportionate impact of the rising food insecurity crisis on Africa. And that crisis has been one that has been ongoing for
quite some time. We're looking at commodity prices, for example, on the continent. We're looking at the cost of energy as well. And then I want to
discuss a number of issues critical to regional peace and security.
In particular for Ghana, Ghana is a member of the Security Council. And I have always engaged with members of the Security Council and tried to
always include members, countries in my travels.
GOLODRYGA: And the other member of the Security Council, I don't have to tell you is Russia and the reason I asked about the timing is because this
comes on the heels of a trip to the region that Russian Foreign Minister Sergei Lavrov was just on last week, he was on a four-nation tour, he
visited Egypt, Ethiopia, Uganda, and Congo.
And he's trying to transform the narrative and saying that the blame isn't on Russia, for the rise in food prices and the scarcity of food, but it's
specifically on the sanctions imposed on Russia by the West. Is there any concern on your end, on the U.S. government's end that that narrative may,
in fact, be effective?
THOMAS-GREENFIELD: What we're concerned about is that that narrative is not factual. The reason that there's a food insecurity crisis on the continent
of Africa, at this moment, is because of Russia's unprovoked attack on Ukraine. These countries dependent on about 75 percent of their food aid
from Russia, as well as from Ukraine. And this unprovoked war has led to shortages, it has led to price increases. And it has led to additional
suffering of the people on the continent of Africa.
Russian food is not sanction by our sanctions. There are no sanctions on any agricultural products from Russia. So it's completely a disinformation
misinformation campaign in which Russia does not want to accept responsibility for what they have done to international food markets across
the continent of Africa.
GOLODRYGA: And are you planning to say what you just told me to the leaders of those countries and those representatives who you are meeting with?
THOMAS-GREENFIELD: You know, I'm going to be listening to them. This, for me, is a listening tour. It is to hear how they want to deal with
addressing the issues related to food insecurity and finding solutions.
[13:15:13]
So I'm not about some blame game. What I'm about is finding a way forward so that we can address the food insecurity needs that people are feeling
every single day. People are starving. People are suffering.
How can I and the U.S. government use our positions to help Africa address these needs. And as you know, administrative power was in the region last
week, discussing food insecurity with African leaders in the horn. Secretary Blinken will be on the continent next week. And all of this is a
lead up to what we will be doing during high-level week in New York in September, and the Africa-Leaders Summit in December that the President
will be hosting.
GOLODRYGA: One solution to this crisis is getting the ships out of port which, if there's any sliver of good news, the first ship did go out this
week, carrying just 26, I believe, thousands tons of corn. That's small relative to the scale of some 20 million tons of food that that have been
stored up there since the war began. That having been said, this is good positive news.
There's another 16 ships that are scheduled to leave port as well, in the days to come. Now this was all because of a broker deal between the United
Nations and Turkey. How confident are you that that Russia will uphold its end of the bargain here and make sure that the chips continue to leave for
it?
THOMAS-GREENFIELD: Well, let me just start by commending the Secretary General and the Turkish government for their engagement to move this
initiative forward. We know how much Russia could be trusted. We saw them attacked a desk support within hours after signing on to the deal.
But that said, we continue to be hopeful, as are the Ukrainians that this will continue, this initiative will move forward and we are able to get
those 20 million tons that are sitting on those 16 ships out to market. And we will continue to support that effort. But we are also very realistic,
and how much we can depend on Russia.
We're hoping that they will honor their commitment and allow those ships to move, as well as move the food that they have in their own markets to the
marketplace.
GOLODRYGA: Well, the numbers and figures are just staggering as you know. As many as 50 million people in 45 countries are now teetering on the brink
of famine, that's according to the U.N.'s World Food Program. As many as 828 million people are malnourished. That's a 1/10 of the world's
population.
Europe, largely views Ukraine and Russia as their breadbasket. But the United States remains the world's largest exporter of agricultural produce.
I'm just curious, what more is the U.S. doing or can the U.S. do? Can you specifically offer in terms of U.S. aid with food shipments, leaving U.S.
ports, some of these countries most in need?
THOMAS-GREENFIELD: Well, first and foremost, we are the largest contributor to World Food Program. We've given World Food Program $3.7 billion this
year. And compare that to what the Russians have given. So first, we're trying to address the humanitarian needs. But I will tell you that I had
Secretary Vilsack join me in New York a few weeks ago to talk about how we can contribute to food assistance here in the United States.
So we're encouraging more production of fertilizer, for example, by American producers. We're supporting American farmers, and the -- their
ability to contribute to this. And as you know, Secretary Blinken was in New York in September as well. And we hosted a ministerial on food
insecurity and came together on a roadmap to address these issues. We've had over 100 countries sign on to that roadmap that commit to working
together to address food insecurity across the globe.
GOLODRYGA: You know, I was with you when you were in Europe, and we were traveling to Romania and Moldova and we got news of the massacre,
perpetrated the hands of Russians in Bucha. And you spoke out against that. We continue to see Russia bombard Ukrainian cities whether it's the port
city of Odesa, whether it's Mykolaiv, and also reports of prison camps being struck.
[13:20:13]
Ukrainian POWs as many as 53 have been said have been killed. The investigation is ongoing now as to determine specifically whether this was
at the direction of Russia that conducted the strike. But this comes as President Zelenskyy once again would like the world to call not only label
Russia terrorist state, but for the United Nations in particular, to remove Russia from the Security Council. What more can you say about that effort?
Is it a real one? Is there a possibility that that can be raised in the weeks ahead?
THOMAS-GREENFIELD: We have successfully isolated Russia in New York. We were able to get 141 countries to condemn Russia in the General Assembly.
We kick them off of the Human Rights Council. And we are continuing our efforts to isolate them.
Russia is a permanent member of Security Council. It is in the U.N. Charter. It's something that we have to deal with. But as we deal with them
and the Security Council, we're pushing back against all of their efforts to put forward a disinformation, misinformation campaign and using their
chair to try to put the blame on others instead of accepting the blame for what they have done.
Russia is responsible for this war, and they're sitting on the Security Council is not going to protect them from the condemnation that they are
facing and will continue to face until they make the decision to withdraw from Ukraine.
GOLODRYGA: Before I let you go, I'd like to get you to respond to what we heard yesterday from U.N. Secretary General Guterres, sounding the alarm
really over the war in Ukraine, nuclear threats in Asia and the Middle East. And he warned that, quote, humanity is just one misunderstanding, one
miscalculation away from nuclear annihilation. That's a pretty ominous warning. Is that something that you share, that the U.S. government shares?
THOMAS-GREENFIELD: We're certainly working to ensure that that does not happen. Secretary Blinken was in New York yesterday at the NPT meeting,
where the Secretary General spoke. It is, obviously, a concern. It's a high priority of the U.S. government to push back on any efforts of by any
country to use nuclear weapons. And we're certainly going to continue to work with our partners, with the United Nations to make sure that what the
Secretary General is predicting doesn't happen.
GOLODRYGA: Ambassador, thank you so much for your time and best of luck on your trip.
THOMAS-GREENFIELD: Good. Thank you very much, and it was great talking to you.
(END VIDEO CLIP)
GOLODRYGA: Well, veterans today across the U.S. are breathing a sigh of relief after the Senate passed long-sought legislation to expand health
care benefits for millions of veterans exposed to toxic burn pits during their military service. Comedian and political activist Jon Stewart, the
lead advocate for veterans on this issue had this to say after the vote.
(BEGIN VIDEO CLIP)
JON STEWART, ACTIVIST & COMEDIAN: I'm not sure I've ever seen a situation where people who have already given so much had to fight so hard to get so
little. And I hope we learn a lesson.
(END VIDEO CLIP)
GOLODRYGA: Correspondent Jessica Dean has more now on what the will do.
JESSICA DEAN, CNN CONGRESSIONAL CORRESPONDENT: Long-sought after legislation that's going to help millions of American veterans who are
exposed to toxic burn pits during their military service passed in a bipartisan vote in the United States Senate on Tuesday night. Now this has
been held up by some Republicans who chief among them is a Pennsylvania Senator Pat Toomey who wanted additional amendment votes to this
legislation.
Eventually, Republicans and Democrats coming to an agreement on how to proceed forward. They did offer some amendment votes. Toomey's amendment,
though, failing. And this legislation as a whole, though, passing. It's been kind of ping pong back and forth around Capitol Hill having to fix
some issues with a previous version of the legislation.
But it now will head to President Joe Biden's desk for final signature and again helping millions of American veterans getting access to health care
that they previously have not had access to expanding different illnesses that will be covered by the VA and that will allow them to get the medical
treatment that they need as they deal with a lot of life-threatening issues and illnesses that were developed and directly linked to their time in
their militaries service.
[13:25:02]
GOLODRYGA: Our thanks to Jessica Dean for that report.
I'm joined now by Jose Ramos, Vice President of the Wounded Warrior Project and Andrew Myatt, an Army veteran diagnosed with adult leukemia. Thank you
both for being with us today. Let me just start with you, Jose, and get your reaction to something that I know you fought so long for to finally
see it passed, headed for the President's desk. What does that feel like for you right now?
JOSE RAMOS, VP, GOVT. & COMMUNITY RELATIONS, WOUNDED WARRIOR PROJECT: Yes, that's a great question. You know, I look at it from both my role here at
Wounded Warrior Project and as a veteran who deployed to Iraq and Afghanistan. And frankly, it's been a long fight. And it's extremely
rewarding to know that we're going to take care of those who have been exposed to toxic exposures, not only in this conflict, but in previous
conflicts.
So it's extremely rewarding. More importantly, it provides a peace of mind knowing, that we're going to take care of those veterans who are exposed,
and that we don't have to fight this fight anymore.
GOLODRYGA: And in terms of who exactly was exposed, let's just give our viewers a sense, 86 percent of post-9/11 veterans who served in Iraq or
Afghanistan say they were exposed to burn pits, according to a 2020 survey. So by no means, is this sort of a narrow sliver that's affecting just a
small population of veterans, this is significant.
And Andrew, this is something that you have dealt with personally. Talk about your health. And when you finally got a sense that something was
bothering you, I know that you were in good health, you took care of yourself, you'd serve for 20 years, you routinely went for health
screenings, and then you got a diagnosis of leukemia, talk about that diagnosis.
ANDREW MYATT, U.S. ARMY VETERAN DIAGNOSED WITH ADULT LEUKEMIA: Actually, I was very fortunate, like I said, I never felt my cancer, it was called on a
routine physical. My hematologist believed it probably manifested two weeks prior to me actually getting full blown cancer. So unlike most veterans, I
was getting regular physicals. I do you have a good health insurance. So, you know, like I said, I was very fortunate. It was kind of a very
surprising rude awakening, when I was told I can't say.
GOLODRYGA: I can only imagine and we're so thankful that with treatment, yes, you were in remission for your leukemia. I know that other
complications then followed, including melanoma. But when did you make the connection that perhaps it was the burn pits that you were exposed to that
led to your cancer?
MYATT: It was through my Veteran Service Officer with Wounded Warrior Project who actually helped me make the correlation. The entire Middle East
is basically a burn pit, at least when we were there actively engaged. So, you know, seeing something burning was just an everyday occurrence, you
didn't really think much about it. And it was -- wasn't until after I was certainly going through my treatment that might be so and actually show me
the data and the research that I've done behind it and kind of explained the cause and effect of it. And it was disheartening,
GOLODRYGA: Jose, how many cases like Andrew's came to you and to your attention in terms of a decline in health and possibly the correlation
between that and burn pit exposure?
RAMOS: Yes, that's a great question. And I think it's really impossible to put a number to it, right? I would say 3.5 million post-9/11 veterans could
have potentially been exposed to toxins based on their deployment in those areas. I've met with countless veterans, both who I served with who we've
lost to toxic exposures. And we've helped countless veterans who have come to Wounded Warrior Project for assistance.
The reality is, is that we don't know how many out there have actually experienced or have some sort of illness. One because it didn't realize
that they were eligible for some sort of care. And two, because they didn't know that it was related to toxic exposures. And I think this conversation
has really helped highlight that, that some of these illnesses and rare conditions are as a result of their exposures. But more importantly, this
legislation allows him to go get that preventative care as well as those benefits and the care that they deserve and that they need now.
GOLODRYGA: As you noted, all the Middle East really in some way it was a toxic burn pit during the combat. Let's just give our viewers a sense of
what these burn pits contain. The waste products, including paint, medical and human waste, chemicals and munitions, unexploded artillery, food, wood,
rubber, aluminum cans, Styrofoam, plastics, petroleum.
I'm just curious for both of you, but let me ask Andrew first, how pervasive were these pits in terms of the impact it had on your life? Did
you ever think that what you were surrounded by could be a hazard to your own health?
[13:30:00]
MYATT: You know, at the time we were more concerned with more immediate hazards, dealing with no enemy engagements. It was just a way of getting
rid of our refuge, I mean, you had to do something with it. And they were everywhere. So, they just kind of became second place.
GOLODRYGA: And Jose, the same for you? Did you ever think twice? Obviously, it makes sense that focusing on the battlefield is where your
priorities were but did you ever wonder what these smoke pits were and if they would impact your health at all?
RAMOS: That's a great question. And as Andrew indicated, we really just focused on the mission. And really that's what everybody does is just focus
on the mission and really don't stop to think about, kind of, the effects of dealing with the exposures until after the fact.
GOLODRYGA: And you do what every soldier does and veteran that has fought to defend this country and that is focus on the mission without politics.
Focus on the task at hand and defending this country, and unfortunately, as we have seen play out, that's not exactly how Washington D.C. works. And
this seemed to be a bipartisan bill that was headed for the president's desk until it hit a roadblock.
And Andrew, what is your reaction to the fact that this bill, bipartisan as it was, was approved by such a lopsided vote? 86 to 11, especially given
that it was over last-minute budgetary technicalities?
MYATT: I mean, it's been a long fight for this, you know, over 13 years just to get to this point. And there was a lot of back and forth. But just
showing that the majority of the Senate voted for the same thing in this day and age shows you the pardons of what they were voting for.
GOLODRYGA: Jose, what will this bill now do in helping veterans? How will this change their lives?
RAMOS: Yes, it's a great question. This bill does a host of things. I think the most important thing is, one, is provide reassurance to those
that the VA is going to take care of them, right. But what it does, from a policy standpoint, it expands health care access to veterans exposed to
toxicant (INAUDIBLE) service. It concedes exposure to burn pits and adds about -- and adds 23 presumptive illnesses. It establishes a framework so
that the VA, in the future, can add new presumptive through a process that's equitable. It also expands presumptive disability-related illnesses
for veterans who served and here exposed to agent orange.
It also directs new research, as well as it directs or requires that VA screen individuals for potential health issues if they were exposed to
toxicants which is extremely impactful from a preventative standpoint. And lastly, more importantly, to execute all this, it allows the VA to increase
capacity through modernization of the claim process, by allowing them to get -- to ensure that they have the facilities that they need. And the
workforce so that they can execute and deliver on the promise made to veterans.
GOLODRYGA: Andrew, how does this impact your life, your health care going forward?
MYATT: Personally, it doesn't impact my health care. My leukemia diagnosis isn't part of this bill. But the important thing in this bill is that
there's 3.5 million veterans who may need health care and don't realize it yet, because you're relatively young when you leave combat. And a lot of
these cancers develop later in life.
GOLODRYGA: What is your message to other veterans out there, Andrew, who may not have been as fortunate as you have been to have quality health
care, and who have been dealing with their own health issues, and not necessarily knowing the cause and unfortunately not necessarily having the
resources to handle them?
MYATT: I would say most definitely go to your VA services or if you have a private provider and get regular physicals. The VA won't give you a
physical, in any way. The sooner they can determine you have something, the easier it is for them to be able to treat it. And then you can deal with
that afterwards.
GOLODRYGA: Jose, you know, we were talking in our show with our producers, and this is an international audience as well, not just domestic. We were
just curious, given the array of troops from various countries who participated in combat, I would imagine this isn't just an exclusively
American problem, American veteran problem. What, if anything, are you hearing from servicemen and women from other countries, from around the
world on this issue?
RAMOS: Good question. You know, the reality is we've been focused so much on what we're seeing here that our attention has remained within the U.S.
armed services. But to your point, we did have allies serving alongside of us around these exposures, and I suspect that they've seen similar
illnesses. And hopefully, they have the ability as well to ensure that those who served downrange were taken care of.
13:35:00]
GOLODRYGA: Andrew, what lessons have been learned or can be learned from this experience? Again, this shouldn't have been a controversial bill. And
yet it took the likes of people like Jon Stewart, the fact that we had veterans and supporters outside the streets there, in the halls of
Congress, making sure that no one left town until there was a vote. What are the lessons learned going forward for veterans who may wonder about
whether their elected representatives really are there to speak out for them?
MYATT: Well, I think the first and the biggest lesson for veterans is that current future leaders learn to mitigate against the risk. And then, as
taxpayers and people that vote, you should really think about who you're voting for and really express your concerns towards whoever your
representative is because, if you don't speak up, you are not listened to.
GOLODRYGA: Well, I want to thank you both, Jose and Andrew, for your service to the country and for your dedication to this cause in making sure
that our veterans are taken care of. You have played a huge role in all of this. And best of luck, Andrew, in your road ahead to recovery. And, Jose,
thank you for everything you have done. We appreciate it.
Well, we turn now to another health concern facing Americans, and that is monkeypox. So far states of emergency have been declared in New York,
Illinois, and California. New York City is the epicenter of the outbreak. According to its Mayor, Eric Adams. And our next guest, Dr. Ashwin Vasan is
that city's health commissioner. He tells Hari Sreenivasan about the risks of the virus, and what needs to be done to protect people.
(BEGIN VIDEO CLIP)
HARI SREENIVASAN, CNN INTERNATIONAL CORRESPONDENT: Bianna, thanks. Dr. Ashwin Vasan, thanks so much for joining us. First of all, this state of
emergency that's been declared by New York about monkeypox, why?
DR. ASHWIN VASAN, COMMISSIONER, NEW YORK CITY DEPARTMENT OF HEALTH: I think it's an important signal that we're treating this with urgency. It's
an important alignment with our state partners. The governor -- Governor Hochul issued a state declaration over the weekend which opens up new
resources for us as well as opportunities to bring in more workforce to vaccinate people. But it's also a chance to signal to the federal
government that we really need fuel resources and an emergency declaration from them to unlock the kind of resources we need to mount the speed of
response that people expect of us.
There are little concrete things around contracting and data sharing as well that are opened up as a result of the declaration. But the most
important thing is that it signals to the public and to the federal government that we need emergency resources now. You know, we're battling
two pandemics. We are still battling COVID on emergency resources. We need new resources to battle monkeypox, as well.
SREENIVASAN: OK, put this in perspective for us. I mean, you're an epidemiologist and you focus on New York City, what have you been seeing
over the past few weeks that gave you enough concern to go to the mayor and the State of New York and say, this is important. We have to escalate the
attention on this.
VASAN: Well, look -- I mean, I think we estimate that up to 150,000 people might be at risk for getting or transmitting monkeypox or having a severe
outcome if they were to get monkeypox. And so, as you can imagine, that's 150,000 people here in New York City that we want to be protected. There
are multiple ways to protect oneself. Obviously, primary prevention and behavior modification is one. But vaccination remains an important tool.
And the fact that we have a vaccine that's effective means we need to get that product out as fast as we can to as many of those 150,000 people we
estimate that want it.
In the last few weeks, you know, we've also seen testing capacity ramp up through our commercial labs, and I appreciate the federal response in
trying to open up those opportunities. But as with that opening up testing, you've seen a dramatic increase in cases. And so, that -- all of that taken
together is pretty concerning.
SREENIVASAN: So, are we seeing the numbers increase because we have the testing now, or has this been in the community spreading without our
ability to test? Meaning, it's actually bigger than what the numbers show?
VASAN: I mean, I think every epidemiologist will say, quite clearly, that we're probably still not testing enough. You know, our first case of
monkeypox in the country was back in May. And New York was the first in the country -- New York City was the first in the country to start vaccinating
people at risk in the end of June because we knew we were underestimating the scale of this outbreak and the scale of transmission.
Now, we're starting to get a little bit of a better handle on the scale of transmission. And what we can see is that there is an enormous demand for
vaccination and prevention. And there are -- you know, there is a significant amount of transmission happening.
[13:40:00]
I still think if we are aggressive over the next four, six, eight weeks with our vaccination campaign and our continued messaging that we can slow
this thing down. But for the next few weeks are critical.
SREENIVASAN: Now, we learned this from COVID that if we were able to get vaccines out, even weeks before we did in certain areas, that we could have
really stemmed the tide on this. So, if we have a vaccine for this, which was the big challenge with the coronavirus, why has it taken so long for us
to, kind of, bring the alarms on this? What happened to that extra month? Why don't -- why aren't there more vaccinations happening today?
VASAN: I mean, I think one thing I alluded to earlier, we're dealing with two pandemics at once. When we had our first cases of MPX, monkeypox that
came into the country, we were in an environment of rising COVID cases at the same time, number one.
Number two, I think this raises the larger question of what are assets in terms of a public health infrastructure, a permanent public health
infrastructure that can turn on a dime and deliver the scale and speed of response that the American people and New Yorkers expect of us. And we've
been running a response for COVID on the back of emergency funds for two years. But we haven't been able to make those permanent investments in
something that's flexible, nimble, data-driven, and can meet people where there are with the kind of speed and effectiveness that people demand.
I hope that this lesson of our response to monkeypox triggers a really open and widescale public conversation about how much we believe in prevention.
How much we believe in public health. We spent $4 trillion on health care. And we spent about three cents on every dollar on public health. And we
need to redress that imbalance if we want the kind of responses that are effective, fast, and able to scale.
It is frustrating. We had a vaccine. We have a treatment. We had a test. And all of it was kind of rolled out more slowly than we would've liked
because of the fact that our permanent public health infrastructure isn't - - has not been invested in for decades.
SREENIVASAN: Brief biology reset for people. How's monkeypox work? What are the symptoms? Why is it so dangerous?
VASAN: So, monkeypox is an orthopoxvirus. It predominately affects the -- it's a dermatological condition predominantly. So, it results in pox or
lesions across the body. And it can result in flu-like illness. It's usually self-limited and self-resolving though it can result in pretty
significant scarring and disfiguration.
And what we're seeing in this current outbreak is that -- is not so much a predominance of lesions on the torso and face and hands which was -- which
is characteristic of the pandemic version in West Africa and Central Africa, but rather more associated with the genital and anal and perianal
regions which is extraordinarily painful.
So, while this may not be a fatal disease in the way that we think of COVID or anything else, it is an extremely painful and unpleasant experience. And
frankly, from a public health standpoint, you know, we shouldn't just be allowing a virus like this to enter our country and become endemic even if
it's not fatal. It's still presenting a significant burden on people.
SREENIVASAN: How long are people contagious?
VASAN: Well -- so, the challenge with monkeypox, of course, is that there is a pretty long incubation period. It can be up to 21 days. And people can
be contagious if they have lesions until such time that those lesions are fully cresting over and healing and there is evidence of new skin regrowth
underneath those scars.
And so, we recommend isolation of up to 21 days until such -- or until such time that people are asymptomatic in those lesions are healing, which is --
which what makes, you know, diagnosis difficult. It makes contact tracing difficult because the time between exposure and onset of symptoms is longer
than something like COVID or something that moves more quickly. So, that's all quite challenging for sure.
We still believe that the predominant mode of contact -- transmission is skin-to-skin. Prolonged skin-to-skin contact. So, not just the casual
brushing by and shaking of hands, but prolonged skin-to-skin contact. And there is increasing evidence that the virus does -- is present in bodily
fluids like saliva, semen, and blood, which -- but it isn't entirely clear yet whether it's formally sexually transmitted. Though intimate contact and
sex is certainly the most high-risk activity that we're seeing associated with transmission in this outbreak.
[13:45:00]
SREENIVASAN: What have been the challenges over the past month to get people to realize that this is serious and that they need to get medical
care?
VASAN: I think it's important to step even further back and look at how we viewed this virus from the beginning. We've known about monkeypox, MPX,
orthopoxvirus from the '70s. And it was really thought to be an African illness. One that is in West and Central Africa. Not a problem for us in
the global north, in Western Europe, in North America.
And so, our preparation for it was not prepared for widespread transmission, but rather potentially weaponization and bioterrorism. Which
is why in our strategic national stockpile, we had relatively small amounts of vaccine, tens of thousands rather than the bigger amounts that we really
need. We had a test, but it wasn't approved for widespread clinical use. And we had a treatment -- we have a treatment but it's only available under
investigational use.
And so, what you're seeing is an entirely, you know, misaligned, in the sense, preparation and now response. But you're seeing the gears turn on
and you're seeing the federal government step up to try to meet that challenge.
But I think we have to start with that fundamental framing that this was a disease over there. Not a problem over here. And there is inherent
structural inequity, racism behind that as well that really makes us feel like we're not connected.
SREENIVASAN: The health data says something around 60 percent of the cases here are in the LGBTQ community, more specifically the male population. So,
what are some of the internal challenges and debates that you've been facing in trying to mobilize for this?
VASAN: I think we've -- you know, we have a long history of engaging the LGBTQ community in public health responses. And they have a long history of
fighting for their health and human rights. Bills off, particularly, the HIV/AIDS Movement. And that's certainly where I started my career learning
from the global HIV/AIDS Movement, around how to center the needs of the LGBTQ community in a global response.
We have a network, certainly, of community partners, and organizations, and advocates that we lean on heavily in terms of developing our messaging.
Really understanding how the science and how people are interpreting that science and how we can deliver the best primary prevention approaches. You
know, I'm also quite aware, and we are all quite aware here at the health department, and frankly, at health departments and all across the country,
of needing to balance the identification of the behaviors that are most at risk and most associated with transmission and the populations.
Because behaviors and identities are two different things. And we're really trying to focus on the behaviors and what we know and what we don't know.
And that's especially important for the LGBTQ population, that has had their sexual behaviors, their social behaviors dissected and prescribed and
judged and, frankly, discriminated against for decades. We take that very seriously because we know stigma and discrimination, it's not just an issue
of politics and language, it's an issue of public health because it pushes people farther into the shadows. It causes them to delay care and worsens
outcomes.
SREENIVASAN: So, even in targeting the behaviors in, maybe, a specific group of people, there seems to be inequity in medical policies over the
decades on how, say, for example, gay men in a certain socioeconomic class or race to get access to care versus people who might be a greater risk,
but not living in the same neighborhood.
VASAN: Look, I think we've tried -- especially with our vaccination campaign, really tried to focus on urgency and equity. And there are tools
we have in our disposal -- at our disposal to try to work on that. You know, we focus a lot on the optics of long lines of people potentially from
certain socioeconomic and racial and demographic groups waiting in line for vaccination.
But what's talked about less are the thousands of doses we are reserving for community-based organizations that really target communities of color,
BIPOC, men who have sex with men, and other LGBTQ communities. We don't talk much about the thousands of doses that we're reserving for HIV
providers and LGBTQ-affirming clinical providers which are trusted and have long-term relationships. And we're not talking too much about our upcoming
mobile vaccinations work to go out into communities, to go to community events, parties, social gatherings where we can meet people where they are.
[13:50:00]
So, I understand there's this baked inequity in our society that often rears its head. It's extremely hard to preserve equity in an environment of
constrained -- extremely constrained supply. But we're using the tools that we have to, kind of, try to create a multidisciplinary approach to get
people multiple doors of entry into preventive care, as well as testing and treatment.
SREENIVASAN: How are you going to be able to measure whether the response to this has been more equitable? I mean, given that you are familiar with
the HIV populations, this is for some of them very painful. This is, you know, bringing back a lot of memories on the types of, sort of, have
discreet differences in how they were not just treated, but what kind of access they have to medicines.
VASAN: Yes, I understand how traumatizing this must be for the gay community and the LGBTQ community. And we also just can't disentangle this
from the fact that we're still dealing with COVID and its aftermath. And so, people are extremely frustrated, extremely tired, and extremely
traumatized from the last several years built on top of this history.
So, that's why we're trying really hard to reach out to our community partners, with whom we have long-term relationships, on things like condom
promotion, on prep for HIV. We're leaning into those relationships because those are long-term trusted relationships with organizations and people
that, certainly the City of New York, is trying to leverage. And I think health departments and authorities across the country are doing the same
thing. Trying to bring in community leaders from the beginning, as we design our response.
Again, a lot of this ends up being extraordinarily hard in an environment of constrained supply. Both the vaccine, but also testing and treatment.
And so, we're encouraged by what steps that Washington is taking to unlock those barriers. But I think at the end of the day we have to go to the root
cause and the fact that these core aspects of the intervention are still taking time to turn on and to be as available as people, rightfully expect.
SREENIVASAN: So, the Biden administration has, at least, appointed leadership to try to mount this response. What are you saying on your
calls, or whatever, to the federal government? What is it that you need now to try to get a handle on this? And I'm sure that your colleagues in other
States that have also declared emergencies are thinking the same thing.
VASAN: Yes, they've been good partners to us. They've been -- we've had open lines of communication from the beginning of this response. The bottom
line is we need more vaccines. We need more access to testing. And we need easier access to treatment. That makes it easier for clinicians to start
people who test positive on treatment that can reduce the symptom burden, reduce the painful side effects of -- the painful effects of the infection.
And we need to do that ASAP. You know, we need to be thinking ahead.
It's encouraging that we got approximately 750,000 new doses into the country. What's next? What's coming after that? Where is the next tranche
of vaccines coming from? You know, we need their support for emergency resources. I said at the outset, we're funding this on our own local funds
in the midst of also funding a COVID response on emergency funds. None of which is building that permanent infrastructure that we need.
So, we need a federal declaration of emergency. And we need to be able to unlock the FEMA reimbursable fund so we can stand up to this kind of
multidisciplinary vaccination campaign. So, we can stand up our media and outreach campaigns and community engagement campaigns that I described. All
of this requires resources. And we certainly need those resources now.
We're very grateful to the -- to their efforts -- for their efforts but I think we all, everyone in this country can say, pretty definitively, we
need more.
SREENIVASAN: Dr. Ashwan Vasan, commissioner of the New York City Department of Health and Mental Hygiene, thanks so much for joining us.
VASAN: Thanks for having me.
(END VIDEO CLIP)
GOLODRYGA: And finally, tonight, we pay tribute to a UK civil rights icon who has died at the age of 93. Roy Hackett was instrumental in organizing
the Bristol Bus Boycott. The 1963 campaign mobilized people across the city to stop using Bristol Omnibus company buses. Why? Because of its refusal to
hire black and Asian people.
Hackett's role in the protest saw the company change its policies and helped pave the way for the race relations act of 1965. The first UK
legislation addressing racial discrimination. He is being honored by the Queen for his contributions to social justice.
[13:55:00]
What an incredible honor. What an incredible legacy.
Well, that is it for now. You can always catch us online on our podcast and across social media. Thank you so much for watching, and goodbye from New
York.
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END
