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SARA SIDNER, SENIOR CORRESPONDENT: Hello, everyone. And welcome to AMANPOUR AND COMPANY. Here is what’s coming up.
President Biden makes a surprise visit to Kyiv to mark the first anniversary of Russia’s full-scale invasion of Ukraine. We have the latest.
Then.
(BEGIN VIDEO CLIP)
DMYTRO KULEBA, UKRAINIAN FOREIGN MINISTER: There will never be enough ammunition as long as the work continues.
(END VIDEO CLIP)
SIDNER: Christiane’s conversation with the Ukrainian foreign minister at the Munich Security Conference. What his country needs as the war enters
its second year. Also.
(BEGIN VIDEO CLIP)
JENS STOLTENBERG, NATO SECRETARY GENERAL: We just need to not underestimate Russia.
(END VIDEO CLIP)
SIDNER: NATO Secretary General Jens Stoltenberg tells Christiane but Moscow’s new movements. Also ahead.
(BEGIN VIDEO CLIP)
DR. ERIC REINHART, POLITICAL ANTHROPOLOGIST AND PHYSICIAN, NORTHWESTERN UNIVERSITY: We, as doctors, want to serve our patients. I really believe
that about the colleagues with whom I work, and we are constantly failing them.
(END VIDEO CLIP)
SIDNER: Physician Dr. Eric Reinhart tells our Michel Martin why doctors are leaving the U.S. health system in droves and what needs to change.
Welcome to the program. I’m Sara Sidner in New York sitting in for Christiane Amanpour.
President Biden dropped into Kyiv this morning for a surprise and historic visit to mark the first anniversary of Russia’s large-scale invasion. You
can see him being received by President Zelenskyy and First Lady Zelenska this morning. It’s the only time in recent history that a sitting U.S.
president has visited an active war zone that doesn’t feature a large U.S. military presence.
Today, the two took part in a wreath laying ceremony at Kyiv’s Memorial Wall and visited a plaque installed to mark Biden’s visit in the Walk of
the Brave in Kyiv’s Constitution Square. President Biden announced half a billion dollars in assistance to Ukraine while there and new sanctions on
Russia. In a press conference, both leaders extolled the virtues of their relationship and Ukraine ‘s fight for freedom.
(BEGIN VIDEO CLIP)
VOLODYMYR ZELENSKYY, UKRAINIAN PRESIDENT (through translator): This is really the most important visit in the whole history of the Ukraine-U.S.
relationship. This is a visit at this most difficult period for Ukraine. When Ukraine is fighting for our own liberty, for the liberties of the
world. And this underlines the results that we have already achieved and what sort of historic achievements we might gain all together with the
whole world, with the United States, with Europe.
JOE BIDEN, U.S. PRESIDENT: Freedom is priceless. It’s worth fighting for, for as long as it takes and that’s how long we’re going to be with you, Mr.
President, for as long as it takes.
(END VIDEO CLIP)
SIDNER: The trip comes just after a heated Munich Security Conference. One, where his vice president, Kamala Harris, accused Russia of crimes
against humanity. And his Secretary of State, Antony Blinken, warned China not to supply arms to Russia as the war drags on. It comes as China’s top
diplomat, Wang Yi, heads for Moscow, and unsurprisingly, there has been pushback from Beijing. The foreign ministry, today, saying the United
States is in no position to make demands of China.
Well, at that Munich conference, Christiane spoke with the Ukrainian foreign minister. He told her what his country needs to keep fighting for
their own sovereignty. Take a listen.
(BEGIN VIDEO CLIP)
CHRISTIANE AMANPOUR, CHIEF INTERNATIONAL ANCHOR: Foreign Minister Dmytro Kuleba, welcome to the program.
DMYTRO KULEBA, UKRAINIAN FOREIGN MINISTER: My pleasure.
AMANPOUR: We’re told that there is a consensus that Vladimir Putin is not ready to engage in any serious round table negotiations. Does that match
with what you know?
KULEBA: Yes, when I look at the update from the front line, I see that whatever Russia says is not looking for negotiations. It’s not looking for
just peace. They are on the offensive. They are sending missiles and drones on our critical energy infrastructure and our cities. We do not behave like
this when you are seeking negotiation.
AMANPOUR: Or when you’re trying to get the upper hand in order to have negotiations.
KULEBA: Absolutely. No, this is — the — he wants war. He wants to destroy Ukraine. And I believe he’s obsessed with this idea.
AMANPOUR: In all your deliberations, your meetings here face to face with many of the world leaders, including your allies who are supporting your
defense. Do you feel that you are now there or on the road to getting what you need to maintain a robust defense and even maybe an offense.
KULEBA: When the war began a year ago, we realized that we need certain types of weapons to become capable of first, defending our territory but
also then liberating our territory. And there are seven types of weapons on this list, I call it the big seven. And in one year we unlocked six out of
seven, it was only fighter planes remaining on the wish list.
Conversation on every type of weapon started with a no. Every single weapon started with a no. In the end, we got it. So, if you look back at history,
of course, we got almost everything that we asked for. And it’s — it required a huge evolution in many capitals, including in D.C., in
Washington.
So, if the word of 2022 for us was weapons. The words for 2023 are speed, speed of delivery, and sustainability. Everything that has been pledged has
to arrive on time to be relevant. It’s important, you know, it has to be relevant. Relevant for the purposes of our victory.
AMANPOUR: And also, ammunition. You need to be able to maintain and supply the weapon systems that they’ve sent you. And we’ve heard at the Munich
Security Conference that there’s a growing worry in Europe that the production of facilities just aren’t as ramped up as they might be in
Russia, which has a permanent production facility. You know, the peace dividend changed the NATO view of war on what they needed to do.
How much does that worry you? How much ammunition are you getting through? I know you’re the foreign minister, but how much does that worry you?
KULEBA: I bet you I can uphold a very detailed conversation on ammunition.
AMANPOUR: Go on then.
KULEBA: Trust me, being a foreign minister that’s what I had to learn or what life force me to learn over the last year. Listen, first, do not
overestimate Russian capacity to produce weapons. Second, our partners have a tool in their hand how to further suppress this production, which is
sanctions.
And we proposed a very specific — for example, we proposed a very specific list of Russian entities involved in the production of missiles. So, put
them on the sanctions. Make their life even more complicated and suppress the production of missiles. Third, there will never be enough ammunition as
long as the war continues.
AMANPOUR: Uh-huh.
KULEBA: This is just a statement of fact. Yes, if you ask me what I need the most here and now, I will say artillery ammunition.
AMANPOUR: Uh-huh.
KULEBA: If you ask me — imagine it’s solved (ph), what’s next? I will say, Howitzers to use this ammunition. And if that is solved, I need tanks
to — and armored vehicles to advance. So, the conversation of ammunition was really important here. And this is why here in Munich I brought
together Ukrainian and German defense industries to sit down and seek solutions of how they can ramp up production.
But be it in the United States or in Germany or in any other country, business need contracts. And to have contracts, you need money. And
therefore, governments who want to support Ukraine, they can finance their own companies by contracting their production of ammunition and other
weapons. And that’s what we are working on.
AMANPOUR: Are you convinced by all the good words you hear that your allies will stay with you to the bitter end or for however long it takes.
And that there’s no peace without Ukraine being at the table. There’s no Ukrainian negotiations without Ukraine, the mantra. Are you sure about that
or do you feel like you’re being encouraged, maybe, to look for areas of a diplomatic possibility?
KULEBA: I don’t believe that someone of our close — some of our closest friends will negotiate behind our backs. So, I have trust in them. Even if
someone decides to do so, I can tell in advance — I’ll take the opportunity of people watching you, whatever you negotiate between our
backs will be rejected by us. Even if you are the closest friend. I think it’s a fair deal.
AMANPOUR: Uh-huh.
KULEBA: I think that the — our friends will stay by us until we win. The question is, of course, how much time would take? We live in democracies.
Governments change, leaders change. So, this is why it is so important to maintain what is bipartisan support in the United States or multipartisan
support here in Germany so that whoever comes to power, the support will be there.
And frankly, yes, I have to be cautious — I have to show some rationality and say that, of course, you cannot trust everyone in this world. But I
think — I don’t think it’s about trust. I think it’s about a group of countries who understand that victory of Ukraine is not only in the best
interest of Ukraine but in their own interest.
AMANPOUR: Yes, and that is what your president said when he came here last year to say, our fight is your fight as well and you need to help. And he
said it again. He portrayed the struggle as David versus Goliath, and that David had to win.
Question is what is winning. We see what your side has put out. We see the 10-point plan. Fundamental in there is that Russia removed itself from all
the territories occupied since 2014. When I asked NATO secretary general or any other government, including the United States, they won’t define what
winning looks like. Again, it’s up to you. But one year later, what does winning look like?
KULEBA: Full restoration of Ukraine’s territorial integrity. This is the first victory that we have to gain on the ground. Then other victories will
follow on, making Russia compensate on bringing perpetrators to account.
But broadly speaking, we have to answer the most important question, what needs to be done to ensure lasting peace in the region and in the whole
Euro-Atlantic area? And this question has two answers. First half of the answer is that Ukraine has to become member of NATO. And the second is
Russia must change. And this is the most intriguing debate that has to unfold. What to do with Russia?
AMANPOUR: Well, what to do with Russia?
KULEBA: Definitely something. Something needs to be done. Russia cannot stay as it is now. Because it’s full of aggression. It’s full of
romanticism (ph). I’m not necessarily saying that it’s something that we, outsiders, have to do with Russia. I think the people of Russia themselves
have to start thinking what needs to be changed for their normal life to be brought back to their daily routine. It’s a complicated issue. There is no
— there are no easy answers at this point. But what I’m trying to say is that in the end, lasting and enduring peace is possible when Russia will
not be posing a threat.
AMANPOUR: You have said that it’s a good deal what you have with your allies. That they supply you with the weapon so that you do the fighting
and they don’t need to fight. Do you think that message has got through? Do you think they think Ukraine is their existential threat as well?
KULEBA: Ukraine is — Russia is there existential.
AMANPOUR: No, I mean — yes.
KULEBA: Ukraine is definitely not their existential threat.
AMANPOUR: I mean, Ukrainian defeat.
KULEBA: It depends on whom you are talking to, but one way or another, yes, they understand it. Because whatever the price of supporting Ukraine
is, the price of fighting on your own, yourself, is — will be much higher.
One thing is to send a tank to Ukraine, and it may be a difficult decision to make, but one thing is to send a tank. Another is to put a young boy
into the tank and send him to die for another country. And I would like to reiterate once more that we never, never ever asked for foreign boots on
the ground in Ukraine. And this is why I called it a fair deal. Unlike so many countries who are calling the United States to step in, to come and
save them. We said we know how to save ourselves. Give us the David’s sling, so to say, to defeat the Goliath.
AMANPOUR: You have been talking, not only to your friends, but to some who are not quite friendly enough. I assume you’ve been meeting with Chinese
ministers, maybe with Indians if they’re here, I don’t know. But there is a group called the global south that is not on board — as on board, Brazil,
et cetera, South Africa even.
Do you have any realistic hope of getting them on board with your — you know, with you? And can you tell us anything about where the Chinese stand?
KULEBA: In the broadest terms possible, I believe that coalitions have been formed and will stay until the end of the war. The more successful
Ukrainian partners will be on the battleground, the more leaning and movement and drifting we will see in this coalitions. But this is in the
broadest terms. There is no universal description of neutrality in this situation because every country is different.
There are 50 shades of neutrality, if I may put it this way. One country votes for us in the United Nations, but doesn’t provide any practical
support. Another country is not voting in the United Nations, is not openly providing support but is doing it discreetly. So, I don’t think there is
kind of one umbrella that you can put all of these countries under it. Everything is very nuanced.
We have certain red lines and we are very clear about it, and there are two of them. The first one, know — if you are calling for peace, make sure
that your peace idea is not based on their — on the need for Ukraine to concede territories. No peace initiative can be based on the idea that
Ukraine has to concede territories. We’ve been there, we’ve seen it, it doesn’t work.
And the second point — second red line, do not provide support to Russia. Be it weapons or circumvention of sanctions, or anything else because
Russia is the aggressor and we are — and Ukraine is exercising the right of self-defense. This is why Ukraine has the right to receive weapons and
Russia doesn’t. If these two red lines are met, I think there is a lot of space for cooperation.
AMANPOUR: Does it hurt you, especially after this whole year, and you’re very eloquent defense and, you know, gathering this coalition of support,
that countries — actually many of them buy Russia’s narrative, at least they say so, that it’s because of the west and because of Ukraine that
there is food poverty around the world. That there is inflation. That there is energy problems around the world.
What do you think when the South Africans or the Indians or wherever they may be say that to you?
KULEBA: Well —
AMANPOUR: That it’s your fault and it’s the west’s fault?
KULEBA: Yes, I’ve been in this business for a while. And I don’t think anything can hurt me in diplomacy. But when I faced countries like this, I
know one simple thing, in the end, it’s only our victory on the battlefield and on the diplomatic arena that will make them change their position.
I tell you, I’ll give you 100 percent that the same countries who are preaching neutrality and all these kinds of things and just — or endorsing
Russian narratives one way or another. Many of them will be reminding us years after how actively they supported Ukraine and that they always stood
by the principle of territorial integrity. They will always remind us of that. And that they were never buying Russian narratives. You have, you
know, to win to change some people. And the same, you know, you have to win to change some countries.
AMANPOUR: How long will it take you to win?
KULEBA: It’s the most painful question. I think we should not be asking this ourselves, this question. I think every day instead of asking
ourselves, how long will it take to win? We should be asking ourselves, what else can I do to make Ukraine win?
It completely changes the optics. Because if you ask the first question, in the end, you get weary, you get tired, right? It still goes on. But if you
are committed to success, it actually motivates you. It moves you, drives you on, it moves you forward.
And we did succeed in changing a very important optics sometime last year because if you see what leaders were saying in the beginning of the war.
They were mostly emphasizing that Russia must not prevail in Ukraine. And we were saying no, this is wrong optics. To get your policies and decisions
right, you have to say Ukraine must win. And now you are hearing more and more of that.
These little things, they really have an impact on what kind of decisions are being made, on what kind of policies are being pursued. So, the same
here.
AMANPOUR: Foreign minister, thank you very much.
KULEBA: Thank you.
(END VIDEO CLIP)
SIDNER: As usual, AMANPOUR doing a very insightful interview there.
Now, this time last year, the world was bracing for a war many expected to last just a matter of days.
Believing the might of Russia would crush its smaller neighbor, Ukraine. Few could’ve imagined the world we live in now, where fierce Ukrainian
resistance and western solidarity held firmer through a year of war. So, what could come next? And will we see something different from Russia or in
the immediate future? Those were the questions Christiane posed to NATO Secretary General Jens Stoltenberg at the Munich Security Conference over
the weekend. Here is that conversation.
(BEGIN VIDEO CLIP)
AMANPOUR: Secretary General, welcome back to the program.
JENS STOLTENBERG, NATO SECRETARY GENERAL: Thanks so much for having me.
AMANPOUR: So, let me talk about Russia because everybody’s talking about, somehow, this war is going to have to end around a negotiating table. Do
you see any sign that Putin is willing to discuss in good faith at this point?
STOLTENBERG: No, we see no sign that President Putin has changed his ambitions in Ukraine. We see the opposite. He’s not planning for peace.
He’s planning for more war, for new offensives. And he has mobilized hundreds of thousands of new troops. He is setting his economy more and
more in the war footing (ph), and then he’s reaching out to other totalitarian (ph) regimes like Iran and North Korea to get more weapons.
So, the only response we can give now is to step our support for Ukraine.
AMANPOUR: So, can I just ask you, what does your intel show because last year everybody’s very clear, Russia is going to invade Ukraine this time
last year. So, what is Russia doing on the border with troops on the ground, with hardware, with aircraft, or anything like that that you can
see that it’s planning for much haunted spring offensive.
STOLTENBERG: What we see there are, first of all, they are launching offensive operations already. And what we have seen around Bakhmut’s is —
and also, all the places on the eastern front, are actually offensive operations. And whether this is the big spring offensive or whether it’s
just a kind of prelude to that, it’s a bit hard to tell.
AMANPOUR: Uh-huh.
STOLTENBERG: But they are pouring in more and more troops and more and more weapons. We also see that, of course, the Russians, they have lower
morale. They have not very good equipment. They have bad leadership, bad logistics. But what they lack in quality, they try to compensate in
quantity because they have mass.
AMANPOUR: So, human waves of cannon fodder.
STOLTENBERG: Yes, and that happens again as it has happened and that’s also the reason why they suffer so many casualties.
AMANPOUR: Uh-huh.
STOLTENBERG: And it’s really — it’s big number, but of course, if you don’t care so much about the loss of human lives, then you just throw in
more and more. And as we also know, of course, is that many of them are convicts. People that are being recruited in the prisons.
So, of course this is a very special form of warfare. Warfare we have not, in fact, seen since the first world war, throwing just waves of people on
the defensive lines of the other part. But this is what is happening in Ukraine.
AMANPOUR: 2023, like World War I, 100 years ago. Do you think, I’d — I think you probably don’t think this from what you’re saying, that Russia
has learned and fixed the problems that has led to what many say, is a debacle for Russian forces over the last year. Has it fixed any of these
problems?
STOLTENBERG: They not fixed all of them, but of course, they learned some lessons and they’re changing their tactics in the way they operate. But
they continue to struggle with low morale. That’s not something you can just fix.
I mean, we speak about an invader who are sending people into another country to try to occupy. And then, of course, it’s always hard to keep a
high morale. And if you recruit a lot of convicts and then put them on the front line just a few days or weeks after we get them out of all the prison
camp, then of course you don’t have high morale.
They are working on logistics. They’re working on equipment. But of course, they are dependent on a lot of old equipment, old ammunition. So, yes, they
have some well-trained forces but even the well-trained forces have not proven to be very capable on the battlefield. But again, mass matters. And
the — and as the general says, quantity has a quality in itself, and that’s the reason why we just need to not underestimate Russia.
AMANPOUR: Right. But — OK. But all the speeches at the Munich Security Conferences, including from yourself, have admitted, acknowledge that
actually this side, your side in Ukraine, is also running out of mass, massive ammunition.
STOLTENBERG: Yes.
AMANPOUR: So, this — you think, would be a window of opportunity while the Russians are still struggling and throwing, as you say, convicts of the
fight. But you’re not able to jump in and take advantage of this window of opportunity because you don’t have enough ammunition.
STOLTENBERG: We have point to that and we have been transparent about the fact that at the current expenditure of ammunition, the expenditure and the
consumption of ammunition is higher than our total production.
And of course, that cannot continue. So far, we have depleted our stocks. But at some stage, of course, we need to get more ammunition produced. We
saw that, actually, last fall because then we saw that this war was moving into a war of attrition and a war of attrition is a battle of logistics.
That’s how do you get enough stuff material, spare parts, ammunition, fuel to the front lines.
So, therefor we have started to work with industry. We convened them at the NATO headquarters. We have a meeting with all the armory factors (ph) from
all NATO allies, and now, allies are starting to ramp up production. The only way to do that is actually to sign contracts with the defense
industry, multi-contracts. And we’re seeing that now starting to take place and our production is increasing but we need to speed it up.
AMANPOUR: And will it happen in time to meet while President Zelenskyy says which is to end this war this year?
STOLTENBERG: Wars are by nature extremely unpredictable. So, I would be careful predicting. Nobody knows today how and when this war will end. But
what we do know is that the only way to ensure these ends in a way which is acceptable for Ukraine is to provide military support to them.
Many wars — maybe also this will end at the negotiating table. But what is happening around that negotiating table is totally dependent on the
strength on the battlefield. So, if you we want Ukraine to prevail as a sovereign nation, and if you want a peaceful negotiated solution tomorrow
then we need to provide military support today.
AMANPOUR: You’re saying that as head of NATO. But do all the constituent parts and governments understand that? Because Ukraine has said, we have
our peace plan and that is Russia gets out of all our territory. Are your governments signed up. Do they — I mean, is Crimea included?
STOLTENBERG: First of all, I think what we have seen is unprecedented support from NATO allies and partners. I think hard —
AMANPOUR: But they never defined winning.
STOLTENBERG: No, but I don’t think it’s for me to sit in Brussels or in Munich to define that.
AMANPOUR: No, but the Ukrainians have —
STOLTENBERG: I think it — but —
AMANPOUR: So, I’m asking you whether that —
STOLTENBERG: It is for the Ukrainians to decide this —
AMANPOUR: They have decided.
STOLTENBERG: Yes, but —
AMANPOUR: They’ve said it publicly.
STOLTENBERG: Yes, but we support them because we need to remember this is a war of aggression. President Putin, Russia has invaded another country.
Ukraine has the right to defend themselves, and that’s actually right. (INAUDIBLE) and he helped them to uphold that right.
AMANPOUR: Right.
STOLTENBERG: Then again, nobody knows exactly how this will end. Maybe it’ll end at the negotiating table. At least this — for the Ukrainians to
decide the conditions. Our responsibility is to support them so they get the best possible conditions.
AMANPOUR: Even in retaking Crimea?
STOLTENBERG: Well, again, this is for Ukraine to decide. We provide them with support and what we have seen is that we are providing them with
unprecedented support. The — President Putin made two big strategic mistakes when he invaded Ukraine. One was to underestimate Ukrainians, the
bravery, the courage of the people, their armed forces, the political leadership. But it also totally underestimated the unity in the strength of
NATO allies and our resolve and full support.
AMANPOUR: Do you think that Putin and his men can take Bakhmut? Because we’re hearing from the U.S. that they’re not sure that that can happen. And
do you think the Ukrainians have been strategically smart to focus so much attention on Bakhmut instead of, maybe, other areas down south which are
equally important?
STOLTENBERG: These are real questions. But as sector general (ph) NATO, we’re very careful to going into those operational details. Partly because
actually some difficult dilemmas to face when you are there — out there making those decisions. But second, I really feel that I should trust the
Ukrainians in making those judgments. They are at the front line, they have — I would say, they are close to the — to what’s going on every day and
they are paying the price, because of course they are paying the price for holding the lines in Bakhmut.
AMANPOUR: 100 percent. And this, as you heard Zelenskyy, the president said yesterday, hurry, hurry, hurry. Speed is of the essence right now. And
you’re basically telling me that we can’t hurry because we don’t actually have the wherewithal and we have to wait to get the production up and
running.
STOLTENBERG: While we are stepping up both the volume but also the speed in which we are delivering aid to Ukraine. Because allies we met in the
NATO headquarters with the defense ministers just earlier this week. And the message from all of them is that we need to deliver more. And that’s
the reason why we are depleting our stocks. Why we are taking weapons we were planning to use for our own defense to deliver to Ukraine because we
realize that if Putin wins in Ukraine, it’s also dangerous for us.
AMANPOUR: Exactly.
STOLTENBERG: So, it’s not only in solidarity with Ukraine, but it’s also because in our security interest to ensure that Putin doesn’t win.
AMANPOUR: So, let me ask you about us, i.e., the NATO nations. I think some of them the Baltic states are kind of concerned because they’re the
closest to any adventurism by Putin. And they are worried that not even a brigade, not even 5,000 soldiers of NATO have gone to sort of be a buffer.
You know, with the hardware and all the rest of it. That the governments either don’t want to or can’t afford to or strapped or whatever. Remember
in the NATO Summit, you announced — I think, even on our air that perhaps 300,000 forces would go to defend that front, and it hasn’t happened.
What’s happening here?
STOLTENBERG: Now, I think I’m mixing two different things. I never announced we have 300,000 troops deployed —
AMANPOUR: No, but you hoped that that would be —
STOLTENBERG: We have — we are starting to develop a new force model and actually we have fundamentally changed how we are conduct — collective
defense in Europe since 2014.
AMANPOUR: Uh-huh.
STOLTENBERG: Because NATO didn’t start to respond to this last year, we started in 2014 —
AMANPOUR: OK.
STOLTENBERG: — when we had the illegal annexation of Crimea and Russia went into Donbas. What we have done since then and what we are now stepping
up is to have more high readiness (ph) forces.
AMANPOUR: Uh-huh.
STOLTENBERG: So, I think it will be absolute meaning — without any meaning to deploy hundreds of thousands of troops to —
AMANPOUR: OK. What about 5,000 in Lithuania, for instance?
STOLTENBERG: It is the common — yes, what we are — what we have decided is to have battle groups there — already there in all the Baltic countries
and in all the eastern allied countries, in eight battle groups, in eight countries. Then we are now, if possible (ph), making them scalable to have
earmarked forces, brigades that can be — that will train, have prepositioned equipment, and then can be quickly deployed.
But more — you know, but even more important is of course that we have hundreds of thousands of troops that will be available for reinforcement. I
think if there’s anything I learned from Ukraine is that you need to be able to move your forces quickly to where they’re needed so we don’t have
to deploy everyone in one specific place.
AMANPOUR: Yes.
STOLTENBERG: But have high readiness, prepositioned equipment. And then these troops we have in the Baltic countries are also backed by a
substantial naval and air forces.
AMANPOUR: Is there a difference between you and Finland, for instance, over joining NATO? You had suggested in the last couple of days that maybe
they could be, you know, separate accessions because a Turkey’s opposition to Sweden for the moment. But the Finnish prime minister today told me no
change. That they are going to join simultaneously.
STOLTENBERG: What I can say is that it’s my position and NATO’s position that is that we invited Finland and Sweden at the same time. We signed the
accession protocols at the same time. And I’m working hard to get them into NATO at the same time as soon as possible. Then I also stated that the most
important thing is not whether they joined exactly at the same time but that both are allowed into NATO as soon as possible.
I went to Ankara earlier this week, we had a good talk also on the issue of membership for Finland and Sweden. The process is moving. Again, it’s for
Turkey to announce what their position is. But at the end of the day, NATO has made the decisions we have made — to make us nice (ph). The
invitation, the signing of the accession protocols.
So, now it’s for each and individual ally to ratify. 28 allies have ratified. And of course, then it’s the Turkey’s decision whether they
ratify two protocols, Finland and Sweden, or only Finland.
AMANPOUR: And yourself, are you going to seek another extension of your term?
STOLTENBERG: No, I made it clear that I’m leaving this autumn. I’m very privileged to have been able to serve NATO for so many years. But I’m
absolutely certain that this great alliance is able to find a good person to follow me a secretary general.
AMANPOUR: So, even if asked, you wouldn’t stay?
STOLTENBERG: It’s actually — to speculate about all these potential things. My main focus now is on how to ensure that this alliance, support
Ukraine, how we are ramping up production, how we ensure our collective defense so this conflict doesn’t escalate and that’s my focus.
AMANPOUR: And just one thing, your term will be defined, I think, by Russia and Ukraine. How have you changed? How is it changed to you in this
last year?
STOLTENBERG: The hopes I had about creating a better relationship with Russia, they have totally disappeared. I grew up after the cold war. I saw
how we were able to gradually improve our relationship with Russia in the 1990s and the beginning of 2000.
And also, as a prime minister in Norway, we actually were able to work together with Russia on many issues. But that has totally evaporated
because of the aggressive actions by Russia that started some years ago, but of course the full-fledged invasion of Ukraine last year was a clear
message that Russia is sort of walking away from any dialogue and cooperation with NATO and the rest.
AMANPOUR: OK. Thank you.
STOLTENBERG: Thank you.
(END VIDEO CLIP)
SIDNER: And tomorrow, Christiane will be anchoring from Warsaw. Covering all the latest from President Biden’s trip to Poland.
Now, turning to a crisis plaguing health care here in the United States, where a number of physicians is dwindling drastically. In 2021 alone,
around 117,000 left the workforce. And one in five doctors say that they plan to leave in the coming years. In his recent opinion for “The New York
Times”, political anthropologist and physician Dr. Eric Reinhart explains the fatal flaws of the country’s health system. And he joins Michel Martin
to discuss the potential solutions to this’s worrying trend.
(BEGIN VIDEO CLIP)
MICHEL MARTIN, CONTRIBUTOR: Dr. Eric Reinhart, thank so much for talking to us today.
DR. ERIC REINHART, POLITICAL ANTHROPOLOGIST AND PHYSICIAN, NORTHWESTERN UNIVERSITY: My pleasure. Thank you.
MARTIN: We’re talking to you about a really powerful, and I would have to say disturbing, essay that you — that was published in “The New York
Times”. An opinion essay. Will you say that, you know, we talk a lot about how doctors and other medical personnel are burned out. But you say they’re
not burned out, they’re demoralized. Talk a little bit about that. Why do you say that?
DR. REINHART: You know, doctors have worked hard for a very long time in the U.S. They have been overworked. They have been exploited by medical
systems. Nothing about that is particularly new. In fact, over the last couple of decades, doctors work hours have declined. We have better working
conditions than we used to have.
But the pandemic disrupted our impression of the system for which we work. I think one of the most demoralizing things, the things that leads to what
has been referred to as burnout is when the system that you work is not serving the ends that it claims to serve. We, as doctors, want to serve our
patients. I really believe that about the colleagues with whom I work, and we are constantly failing them. Not through any lack of effort on our part
but because our health systems and our welfare systems are not set up to allow us to succeed.
And doctors have played a very large part in producing that reality over a long historical period. We have, in some sense, allowed ourself to be paid
off. We have highest in the world compensation for physicians, and we work in the least effective health care system in the world among wealthy
nations. We have dramatically poor mortality, for example, then peer nations.
MARTIN: So, it’s — in a way, it’s like you’re saying that there is, like, a big lie, you know, at the heart of the profession. I mean, we’ve
talked a lot about how, you know, nurses and other medical personnel are leaving the field. Nurses in particular, we gotten a lot of attention in
part because the COVID pandemic. But you’re saying that physicians are also leaving the field. And if they haven’t, they’re talking about it. Why do
you think that is, like, why now?
DR. REINHART: I think why all of these groups are now unable to sustain the belief that they used to have in the systems or at least some marginal
belief, is because the pandemic accelerated death. Bureaucratically ordained death that didn’t have to be. Put it at a rate that we had never
seen before. There was a study in the proceedings at the National Academy of Sciences, a top science journal, that estimated 338,000 lives could’ve
been saved had we had a universal health care system in the U.S. like every other industrialization in the world has.
When you’re working as a doctor or a nurse or a staff member at a nursing home, and you are seeing death after death that did not have to happen, and
your reading about it constantly in the news. “The New York Times” has been publishing expose after expose of the corruption in the health care system
and who is profiting from, who is deliberative designing the systems to produce these outcomes.
This set is — has led to what I call in the SA collapse of American medical ideology. That is the stories that we have told ourselves about
ourselves for so long. That have sustained our motivation despite poor working conditions, despite the fact that trainees and nurses and doctors,
even senior doctors are exploited by this system. We have been able to sustain some belief that our work mattered. That it was virtuous. It was
part of a moral enterprise. I think that a vision of ourselves is collapsing now.
MARTIN: Well, you call it corruption. Why do you use that worried? I mean, you — it sounds to me like this is the way it’s designed to work in a way
except for the fact that it’s now collapsing.
DR. REINHART: I don’t mean corruption in legal terms, per se. But I think what you have is a field that is entirely inconsistent with the ethical
values that it holds up. If you go through medical schools right now in the U.S., you will hear in every single medical school that you might attend,
long speeches about health equity, health justice, how this is what our institution is designed to serve. And then you go work in the hospitals.
I’ve had experiences like this.
And you that — actually the policies that dictate who comes into this hospital, what kind of care they get, what kind of aftercare they don’t get
is not guided by the ideas of health equity or health justice or even care. It’s guided by a goal of maximizing revenue, and in many cases profit.
MARTIN: So, you — so, let’s just say at the core of it you say is the for-profit model.
At the core of it is that American health care is primarily delivered through for-profit mechanisms, even institutions that are ostensibly not-
for-profit, right? They’re still operating under a profit motive, right? And so, your argument is that this leads to fundamentally terrible outcomes
that patients get inferior care and that the medical personnel, doctors included, just can’t basically kind of keep up. They can’t fulfill their
ethical obligation to care for people because of that. Tell me why you’re so convinced that that is at the root of the problem.
DR. REINHART: You know, there is a tradition that I come out of, it’s called social medicine. It’s founded by this pathologist in Germany, Rudolf
Virchow. He went to steady an epidemic in Upper Silesia, a typhus epidemic. And he’s a specialist in pathology. And the first thing that he realized
when he got there and he was studying this epidemic was that it wasn’t his pathological knowledge that mattered, it was housing, it was labor
conditions. These were the determinants of health.
In the U.S., those things are determined by policy. They are the political determinants of health. The U.S. medical profession has fashioned itself
for well over a half century around suppressing its awareness. That what we do is the product of policy decisions. And if we do not engage in political
struggle to try to advance of quality of life for our patients, we cannot fulfill our ethical obligations. This, in my view, is a — an obvious
reality. This is true everywhere in the world.
U.S. doctors, historically, have refused this. They say medicine is a scientific enterprise. It is not a political enterprise. Why are you trying
to bring politics into this? And I think that has, overtime, hollowed out the ethical claims of the field.
In my view, ethics in medicine in any scene in life has to be accountable to its effects. If you are ethical framework is producing effects that kill
people who do not need to die simply because they have been deprived of care because they cannot pay, that in my view, is not an ethical system.
Ethics without a paired politics to advance the ideals you claim to subscribe to is largely meaningless. It’s many ways, it’s worse than
nothing.
MARTIN: But why are you so convinced that that is at the core of the problem as opposed to, I don’t know, decoupling, say, health insurance from
your job or something like that. Well, I guess by some center that would be universal health care. I mean — so, people do think we — they’re, by some
measure, we have universal health care now because we do have the Affordable Care Act that people have access to health care who didn’t have
it before. Millions of people do. Why, in your view, has that not fixed the problem?
DR. REINHART: Just to clarify for that last point. You’re right that Affordable Care Act dramatically expanded health care access, this is
extraordinarily important. But there are still over 30 million Americans who do not have health insurance and do not have continuous health care
access. They can only get access only through emergency departments. And it’s very substandard care. It’s broken off. It’s very ineffective. It
leads a lot to medical errors.
And there’s also the fact that people who do insurance are underinsured. I work at a hospital where I can’t treat a lot of patients who come in with
certain kinds of insurance. I have to refer them out. Sometimes it takes days for them to be transferred from our emergency department to another
hospital. And that’s not unique to my hospital. I’m not a fan of that policy. But that’s true at countless hospitals around the country.
So, simply the fact of insurance coverage does not insure good care. And I think the fundamental group of what determines care structures and all of
these contexts is around motivation. And that is imbricated with for-profit pharma system, a for-profit insurance system. The Affordable Care Act
expanded health care access, which is very important, but it also more deeply entrenched the insurance structure. Do you have private insurance
that are making money off of this. So, it also enhanced insurance company profit substantially.
What you’ve seen during the pandemic, for example, as hundreds of thousands of people have died unnecessarily are record profits in many hospitals, in
the pharmaceutical industry, and the insurance industry. What we have is a fundamental decoupling of health care, of actual care and health outcomes
with — and the goals of the system.
MARTIN: And you really point the finger at doctors for this. You don’t really come right out and say this. But I think that your argument is at
its core that doctors are really to blame for this. Because of their need, desire for status and money. Is that fair?
DR. REINHART: Yes and no. So, it’s a very complex issue with a lot of different actors. The reason I start with doctors is because I, myself, am
doctor. I’m speaking from within the medical institution and I believe that once first ethical accountability when you’re a part of any powerful
institution is to hold it accountable to its ideals.
So, I’m going to call out my colleagues because I think we can do something about this. There is an excellent essay in “The New Yorker” that a senior
physician, Eric Topol, published a few years ago. It’s called, “Why Doctors Should Organize.” And part of what he says in this essay is that doctors
are often resistant to the idea that we should be politically organizing for care and such, that’s not our domain.
He says, actually, doctors have been organizing for decades, we’ve just been organizing to enhance our income, enhance our political power. We have
not been organizing on behalf of the patients.
And this is true. If you study the history of U.S. medicine, you can see from the 1930s and ’40s in California that it becomes — it passes to the
EMA. They become a very powerful institution. They’re less powerful now in some ways but they’re a historical momentum in terms the system they have
put in place persists. And those systems were put in place to protect American doctors against the specter of socialized medicine.
Even as the people who were saying that we need to keep away from this recognize that it would lead to improve patient outcomes and patient care,
but their concern was that it would reduce doctor’s income, it would reduce their status. It might make them secondary actors rather than primary
actors in the health care field. What we see now is a consequence of that for our health care system but also for health systems, not just health
care.
The most important part of health in any context, in a national context is not health care, it’s the preventative systems that supply the basis for
public health. Those are fundamentally interwoven with basic social services like housing, et cetera. What you have is a medical profession
that is advocated it’s — for itself for so long and has obtained so much power and wealth in the process that it has cannibalized public health.
Doctors have been leading in public health. They are, in fact, not necessarily expressly in public health. Medical interventions constitute
only 10 to 20 percent of the determinants of health. 80 to 90 percent of the relevant knowledge for public health is not within the medical field,
it’s in labor history, sociology, communications, environmental science. Why are these people — and it’s also in the knowledge that communities who
are excluded from our current system have about the obstacles they face. They know how to design systems from the bottom up, which is how you always
have to design public health system for them to be effective.
MARTIN: You know, there is a group of doctors that have been saying this for a very long time, they’re black doctors. OK. Black doctors, like in the
National Medical Association, which was formed because the AMA, the American Medical Association, would not allow black doctors to join, and in
some cases, they excluded them from privileges at white hospitals. Black doctors have been saying this for quite some time, in fact, you know, for
decades. Why haven’t the other folks in the profession listened to them?
DR. REINHART: This could be an important point. I think whenever you design any system, you have to design it from the bottom up. So, not just
public health, but if you’re talking about health care profession, to make it be ethical and accountable to its members, it should always be looking
at those who have historically been most excluded and empowering them to lead the field forward. So, it has to be less exclusive than it has been,
to be better than it has been.
I think black doctors in the U.S. have a very important position, and they are leveraging it. A colleague of mine, Alicia Maibing (ph), he’s actually
working for the AMA to try to promote health equity. There are limits to working within such powerful institutions whose intrinsic motivations are
not necessarily in line with this. I think this is what a lot of black doctors and other progressive doctors around the country have faced.
We can I advocate for these things, but if we are working within an extremely powerful systems and the majority of physicians around us do not
very actively join us, it’s very hard to upend the power structures. It’s much easier, frankly, for those power structures to absorb dissidents into
positions of leadership and in the process, silence them. And I don’t mean that the doctors themselves have bad motivations, we realize this is
happening. This is a structural force, and we see this all the time.
MARTIN: But that’s why you advocate for doctors unionizing. And I’m just trying to figure out, you know, that’s one of the things that you suggest
in your piece is that doctors should unionize. But I’m just trying to understand how that actually works. And frankly, I am just curious how you
overcome this sort of cultural resistance that the people who are currently in the field have to this, they are just not used to thinking of themselves
in that way. So, I’m just curious like why you think unionizing solves this problem?
DR. REINHART: Yes, I don’t. I think it’s an important step. I think doctors need to learn to organize together and organize beyond their field,
need to organize with other health care workers, with techs, with nurses, and beyond that, they need to organize with their patients. We need to
organize with our communities and ground ourselves in those, not in the values of these powerful very wealthy health care institutions for which we
work. I think one step that is immediately achievable that doctors can take towards that is to begin to organize together.
MARTIN: Are you convinced that most of your colleagues agree with you on the problem, ff not the solutions?
DR. REINHART: I think the doctors of my generation, younger generations, by and large, yes. They agree. I think the doctors who have been in this
system and have been rewarded for loyalty to the system for a very longest time, and I think they’re wonderful human beings, many of them. I don’t
mean that they’re bad people, but there is a structural determination of how they see the world. This part of medical ideology, the thing that’s
collapsing, the story that we have told ourselves has been so core to their identity, their moral identity in the world, their ethical identity, their
political identity.
So, for them to be able to do an about-face and recognize that there is some level of responsibility for enormous harm that has been done, I think
it’s very difficult. And I think we need to figure out how to bring these people in in a way that’s gentle, in some kind of way, but also being very
hard about the reality that we have to face and that we need to do this not just for our own moral integrity but because people are dying, literally
every single day, that refused to confront this.
MARTIN: Dr. Reinhart, doctor shows are a staple of television. Doctor shows on television are just filled with these kinds of storylines.
DR. REINHART: Yes.
MARTIN: You know, they are filled with the idealistic young doctor who comes in and says, well, this isn’t right, you know, this person needs
health care and I can’t do it, and they fight the system and then, they go down in flames. It’s just interesting that, as a culture, we kind of accept
that story but we don’t do anything about it. You know, I’m just curious like what do you think of that, if you think about that.
DR. REINHART: I think about this all the time, and I think that’s a really, really important point. And I think a lot of young doctors have —
they still hold on to these ideals of equity, of justice, they hate it when they have to exclude patients from care, when we see our patients suffer
for preventable reasons. And there’s a dedication to this idea of the great doctor, the great humanitarian who is going to sacrifice themselves for
this. And this is part of why we’re so easily exploited.
Many people in the field are very idealistic. They are happy to work 120 hours a week if they think that it matters. I mean, I often work over 120
hours a week because I think it matters. I don’t know how that’s clinical. But the problem with that is something that Che Guevara pointed out, a
physician that’s part of the social medicine tradition. He gave a speech in about 1960, we called “On Revolutionary Medicine.” He described it in his
own biography.
He said, you know, I trained as a doctor and I had this vision of myself as the heroic doctor who would redeem the world in front of me. And overtime,
I’ve realized that that fantasy is part of the problem. It’s not individual heroes who are going to be able to do the work that we need to do. We have
to bind together at the collective, and not just as a collective of doctors, as a collective — you know, well beyond that.
In terms (ph) of our rights (ph) about the entire population working on itself, that would be caring for itself. That would be revolutionary
medicine. You can have revolutionary medicine from a single doctor or single group of doctors or a single hospital, it has to be a collective
mobilization.
MARTIN: Is there any part of you that’s kind of burned out or demoralized? And if so, what do you say to yourself to get up in the morning?
DR. REINHART: It’s those relationships with people who are working every day to address the problems that I’m thinking about all the time even as I
work in a hospital, I can’t address them. It’s my relationships from my long — my decade (ph) ethnographic work from the south (ph) in Westsides
of Chicago of people who are suffering from health care exclusion, who can’t get access to housing. I leave the hospital and I am demoralized,
very often. I’m frustrated that I couldn’t do better by my patients. I don’t have the resources to do it.
But then I get a call from somebody who wants me to come visit them, because they are having a difficult day, that is what gives me a sense of
meaning and continuation. So, I think that’s how we counter demoralization. We bond together in relationships and in collective movements to make
things better.
MARTIN: Dr. Eric Reinhart, thank you so much for talking with us today.
DR. REINHART: Thank you for your time.
(END VIDEO CLIP)
SIDNEY: What a fascinating conversation. And finally, awards season is in full swing. Last night, the Red Carpet was rolled out for the British
Academy Film Awards, better known as the BAFTAs. Dominating the event with seven wins, including best picture and best director, the antiwar film “All
Quiet on the Western Front” set in the trenches of World War I.
The film is based on a 1929 novel and the director, Edward Berger, recently spoke with Christiane about why he was motivated to take on this classic.
(BEGIN VIDEO CLIP)
EDWARD BERGER, DIRECTOR, “ALL QUIET ON THE WESTERN FRONT”: Obviously, in Germany, we grew up with the inheritance, with the DNA of war, of what
Germany has brought to the world. And so, I always feel a deep sense of guilt or shame and responsibility towards that history, to talk about that,
to make sure that we don’t forget what we did.
(END VIDEO CLIP)
SIDNER: Another winner, the CNN film “Navalny,” scooped best documentary. It’s about the poisoning of Russian opposition leader Alexei Navalny, who
is currently in jail. This is what his daughter Dasha had to say when she was on the Red Carpet in London.
(BEGIN VIDEO CLIP)
DASHA NAVALNAYA, DAUGHTER OF ALEXEI NAVALNY: Thanks to our amazing, incredible, very passionate, very talented team, we are here. I’m very
happy that the story about my father and about the work that he’s doing is getting noticed. It’s amazing.
I think it’s very important to remember to fight for your freedom and for democracy around the world. You know, I’m in the U.K. right now and I study
at Stanford in the United States, and not a lot of people remember that Russia is not a democratic country, and we are really trying to fight for
the freedom of the people over there.
(END VIDEO CLIP)
SIDNEY: I have to say, I have seen both, and they are both really, really good, but I particularly like “Navalny.” I know, it is helped put on the
screen by our company, but it is so good. Please take a look at it. And next month, it’s the Oscars. Good luck to all nominees.
That is it for now for us. Thank you so much for watching and goodbye from New York.