♪ Christiane: Hello, everyone, and welcome to "Amanpour and Company ."

Here is what is coming up.

Dr. Fauci: If we go into the next pandemic in a discombobulated way, it will be even worse.

>> Dr. Anthony Fauci, his experience as chief medical advisor, and why science is the only way to get through the next pandemic.

And what went right and wrong heavenly -- handling COVID.

Then, what's love got to do with that?

Filmmaker Jemima Khan talks to me about arranged marriage and her rom-com.

Also ahead -- >> It is a black box science does not understand.

>> Investigative journalist Emily Witt takes Michel Martin to the cutting-edge of reproductive science.

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Christiane: Welcome to the program, everyone.

I am Christiane Amanpour in New York.

Three years after this strange new killer disease swept the globe the world is now moving on , from COVID, and all of that pain and loss.

The U.K. has shut down its COVID app required to show vaccination status to Interpublic places.

Officials say the virus has killed more than one million people here in the U.S. and about 7 million worldwide.

But my first guest tonight says that is an underestimate.

The real death toll could be 20 million, and it would we have been double that without the vaccine.

Dr. Anthony Fauci was undoubtedly the face of the COVID response as chief medical visor to the president.

We met up here in New York as he received the prestigious Calderon prize from Columbia's School of Public Health.

Dr. Fauci, welcome back to our program.

Dr. Fauci: thank you.

Good to be with you.

Christiane: Congratulations on this major award for public health.

At the gala event, you gave a pretty profound and passionate plea to the public health community in the audience.

What were you trying to tell them?

Dr. Fauci: Well, the point I was trying to make his we have been through an extraordinary ordeal with these three and a quarter years of COVID-19, and there is a lot of activity now looking at lessons learned, what went right, what went wrong, how can we better prepared to and respond to future pandemics, and unfortunately, I think, as everyone realizes, there's been a lot of polarization that has gone on over the last few years of things that should have been purely public health issues.

There has been a lot of misinformation and disinformation and distortion of truth and reality.

My plea to them was that we really needed the serious academic, scholarly approach to an analysis of what went on, rather than giving way to some of the obvious litigation that goes on.

-- Paula does ancient -- politics that goes on.

We are living in an era, what I call the normalization of untruths, where there is such a distortion of reality that the public gets used to it, it is like normal, natural, people are saying that.

It is a dangerous situation to get into, because when you do accept the normalization of untruths, and you don't have pushback from people who actually are using evidence-based and data-based statements, then reality gets totally distorted.

I think that is dangerous, not only in the arena of public health, I actually think, not to get too melodramatic about it, that it really is sort of -- erodes the foundations of democracy.

Christiane: You had to go through and talked about it.

Let me read what you said to Congress, I've had threats upon my life, harassment to my family, my children.

I've received phone calls because of people lying about me , lying about you and the science you have had guards 24/7 keeping you safe.

What did that say to public health officials, and to yourself, about waging this war in the future or the struggle for life?

Dr. Fauci: To me, it tells me we have to do it, and we cannot be dissuaded to do it because of threats.

I am a visible public figure, but many of my less well-known colleagues who speak out the truth about things almost instantaneously, from the time they do that, I do not know whether it was bots or real people start making harassing threats to that.

We cannot yield in the faith of that, because it is such -- in the face of that, because it is such an important issue.

And that is one of the reasons why I will try to continue to inspire and encourage, particularly young people, to get involved in medicine, science, public health and perhaps even public service, which I think is so important.

Christiane: Because the key obviously is, right?

Obviously lives.

What keeps you up at night, given how the experience of what happened with the Covid 19 pandemic, nationally and globally, the next pandemic will be addressed?

Dr. Fauci: That is what I worry about.

If we go into the next pandemic in a discombobulated way, it will be worse than what we see right now.

I tend to look at this into buckets of preparedness and response, one is the scientific fairness and response, the other is the public health preparedness and response.

What was a resounding success was the science.

I mean, to be able to have the sustained investment in clinical and biomedical research that allowed us literally, within days of getting the sequence of the virus to begin the vaccine development program to be in a phase one trial in 65 days and at the end of 11 months to have a vaccine that was safe and effective, that is beyond unprecedented.

If we were having this conversation 10 years ago, I would have told you that is nuts.

There's no chance that is going to happen.

That was a result of sustained investment in basic biomedical research.

What did not go as well was public outcome of the infrastructure, communication, the ability to get data in real-time as opposed to waiting weeks and months to make the data that would inform decisions we would have to make.

That has to improve.

Christiane: The Covid report that has recently been released by a bipartisan group of mainstream medical community and others have listed a bunch of things that could have gone better.

COVID war revealed a collective national incompetence in governance.

There was a delay in response, poor communication during both the Trump and Biden administrations, and here, 500,000 deaths could have been prevented, even though the U.S. spent $5 trillion.

You have been asked a lot about this "Monday morning quarterbacking."

Are these valid points?

Dr. Fauci: I think they are, for the most part, valid points, and if you take each one of them, you can see what the underlying reason for that was it we have in our country, first of all, the idea of being able to get data in real-time.

It is embarrassing that other countries like Israel and South Africa and the U.K. have health systems where data is fed in, in real-time, and you know what is going on the next day, the next week, where it takes us sometimes months to figure out what is happening, and when you are dealing with a rapidly moving pandemic, that is unacceptable.

That is the first thing.

The other thing is the divisiveness and the politicization that occurred where you have leadership in the beginning, a denial that this was a problem, and that is when I had to come into an unwanted conflict with the president, when he was saying, is it going to go away like magic, it is going to be gone, you know, don't worry about it, and I had to come forth and say that is not the case, I'm sorry, I do not mean any disrespect to the presidency, but this is not correct.

The other thing they bring up is the fractured nature of our approach appeared one of the beauties of our country is that we are a very diverse country you, culturally, economically, and we have 50 states and more territories who have the ability to be able to do things their own way.

That is beautiful when you want to be able to accommodate the diversity in the country, but when you have a common enemy, the virus, and you have people doing things in multiple different ways, that is not a coordinated response to a pandemic.

So many of the things you mentioned, Christiane, our valid points.

Christiane: There are many instances, the fisticuffs with people in Congress, presidential candidates, senators, governors, DeSantis, you know, and other people who just basically blame you, they basically blame you.

They said everything you did was contrary to saving lives, as if you were in full charge.

I realize you are going to say, well, no, I was not in full charge.

I want to know what you think you and the community got wrong.

Once the closing of the schools too draconian?

How much was the delay that nobody understood the asymptomatic spread of this, nobody figured out it could actually bust through certain vaccine levels as well.

What are the real takeaways, the real lesson?

Dr. Fauci: yeah.

I think we have to get away from the blame game, because so many things you have mentioned were unknowns at the time.

It is so easy -- and I made that comment in my response to one of the questions that Davis Wallace Wells asked me -- Christiane: This was in the "New York Times" profile.

Dr. Fauci: And I did not mean this as an affront to him, but I said this is big time Monday morning quarterbacking, which is what it is paired rather than having a blame game, which is what we have to stay away from, there were things that happened, and it was a moving target, and there were things that you did not know at the time, and you had to come out of necessity, make a decision.

Sometimes the decision was partially right, for example, let me give you an example of a partially right decision.

I think the idea when you are having trucks that were cooler trucks pulling up to hospitals in order to put bodies in because the morgues were overflowing and the hospital beds were being challenged that you had a triage, you had to shut down.

I do not think anybody who has any realistic evaluation knows that you have got to do something dramatic.

Once that is done, then the thing you need to now go back and analyze, I don't think anybody would argue with the fact that you had to shut down, is how long you keep the shut down and how complete it is.

How does that relate to schools, when you shut down schools, if you do, and I have been very vocal about this, and I think the people who like to point fingers, I say go and look at the tape, you know, the tale of the tape, when I kept on saying over and over again, we've got to get the children back to school as quickly as possible we've got to get them in schools safely, and we've got to make sure that they are not essentially out of school, at home, getting all of the negative consequences.

Different parts of the country interpreted that differently.

There were schools that stayed closed far too long and longer than they should have, and there were those that essentially did not close at all.

My daughter is a schoolteacher in New Orleans.

They closed down for two weeks and were essentially open for the rest of the time.

Christiane: And the result was?

Dr. Fauci: They did not do too badly.

The kids got infected, a lot of them did, you know, virtually.

It was very difficult to determine and say, well, if you shut down this long, you get no negative effect on the child and minimal effect on the infection.

Those studies were not done.

It was just trying to do as best as you can in the circumstances that you were in.

Christiane: Can I ask you, because you are no stranger to very, very difficult public-health decisions, you know, obviously we all know you came to massive prominence during the HIV.

There was a huge backlash from the community against you at the beginning, and then you sat down, talked to them, and it became an amazing partnership, and you were responsible for the antivirals, and it had an amazing effect on public health.

Can you describe or contrast the backlash that you had from the AIDS community at the beginning compared to the MAGA community -- or whoever was against you -- in COVID?

Dr. Fauci: It was as different as apples and watermelons.

It was really different.

And the differences are sometimes misunderstood.

Back in the 1980's, when we were dealing with the mostly young, gay activist community, the point that they were trying to make, they were trying to get the attention of the scientific community and the regulatory community to say we want to be part of the process of the design of clinical trials, of attention played -- paid to this, of the rigidity of the regulatory process, because the scientific and regulatory process worked extremely well for other diseases but was ill- suited for the emergent nature of a disease that was mysterious and that was killing young men -- they did not even know they were infected until years later, when they were starting to deteriorate from a health standpoint.

They wanted to say listen, you are having clinical trials.

There are no real drugs available.

We want to be part of the design of the clinical trial process.

We want less rigidity in the regulatory process.

So what they did to gain attention, they became theatrical, iconoclastic, confrontation of, disruptive.

They got my attention, they did, and when I listened to what they were saying, it was evidently clear to me that what they were saying was absolutely making perfect sense, and if I were in their shoes, I would have been doing the same thing that they were doing.

That turned me around completely.

It made me embrace their activism and say, now we've got to change the system.

We've got to get you involved from the ground floor, in the design of the trials, and the regulatory process, so that we can work as a team.

That is very different from a group that is pushing back with misinformation, disinformation, conspiracy theories, outright lies, essentially saying vaccines don't work, making up things, that we are putting chips in vaccines, getting people to not want to, essentially, utilize life-saving interventions.

That was very painful to me, as a physician, because my entire DNA has been to alleviate suffering and save lives, and when you have people who are pushing back against you, but what they are pushing back against is trying to give disinformation that we give people not to utilize life-saving interventions.

That is a big difference between the anti--found attention -- anti-Fauci attention-getting that the gay activists did which is based on a noble and point versus pushing back and spreading misinformation.

Christiane: Obviously the whole lab leak theory and the origin of this, I think you still say it is not clear -- Dr. Fauci: Right.

Christiane: What is your view today about?

Dr. Fauci: First you have to keep an open mind, because we do not know definitively what it is, and when you do not know definitively, you've got to keep an open mind to all possibilities.

If we get a definitive determination, I will certainly embrace that fully.

Right now, because we do not know what it is, instead of pointing fingers and blaming, we can say it is either one or the other.

That being vague case, let's start right now mitigating against the possibility that this would happen again versus that would happen again, the two possibilities, you know, lab leak versus natural occurrence.

Having said that, with an open mind, as a scientist, I have to look at the data and say although either is possible, that does not necessarily mean they are equally probable.

And if you look at the data that has been accumulating over the last year, several months, even most recently, it is pointing more strongly toward a natural occurrence, but it has not been definitively shown, so as long as that still remains the situation, you must entertain the possibility of both, and that is exactly where I stand.

Christiane: So finally, how did you feel, personally?

You have been through the ringer.

How is Anthony Fauci?

Dr. Fauci: I'm actually fine.

I really am.

Certainly it has been a trying and difficult time.

But, as I have always said, and I mean that succeeded -- sincerely, you know, as a physician and a scientist and someone who cares deeply about individual health and public health, even at a global level, I just focus like a laser beam on what my mission and my goal is, and my mission and my goal is to do whatever I can to safeguard the health and the safety of the American public, and then therefore indirectly of the world, because of leadership.

Everything else, quite frankly, Christiane, and I mean it, is noise, the noise of the attacks and even the somewhat amusing noise of the idolization.

Both of them are unrealistic.

I know who I am, and I know what my goal is, and that is how I get through this.

The only thing I don't really like about it is the impact it has on my family, my wife and my children, when you get attacks like that.

But apart from that, the rest of it is noise.

Christiane: Thank you very much indeed, and congratulations on this honor.

Dr. Fauci: thank you very much.

It is good to be with you.

Christiane: A true public servant.

Next to the world of Ron come -- rom-coms in modern life.

The genre is experiencing a surge with a more female perspective.

The producer and screenwriter Jemima Khan experiences arranged marriage in her cross-cultural comedy "what's love got to do with it?"

Some of it is based on her own experience as the wife of Pakistan's Prime Minister.

>> Ideas for your next film?

>> I follow my childhood.

>> An arranged wedding.

>> Parents first.

>> Hold on.

>> Call in the matchmaker.

>> Photos?

>> No, no photos yet.

Christiane: A big success in the U.K., the film opens in the U.K. -- U.S. on Friday.

Jemima, welcome to the program.

Jacob: Thank you for having me.

-- Jemima: Thank you for having me.

Christiane: I need to start by saying we have been friends for a long, long time, more than 20 years.

I did not know you were planning on writing this film.

Where'd you get that inspiration?

Jemima: It has taken a long time.

Took me over 10 years.

It is obviously inspired by my 10 years I spent living in Pakistan.

Pretty much every character I've met somewhere along the way on my journey and also every line, every joke, every anecdote is sort of pilfered from real life, but it is just a very long time to realize.

Christiane: And you wrote it on your own?

Jemima: I did.

I have a production company, and I make document race in the U.S. and the U.K.

I was doing this in my spare time.

It was important for me to do this on my own, because I felt that, apart from anything else, this was a real challenge, but also, I did not want the assumption that I was just given a storyline and some ideas, and boy was it a grasp.

Christiane: Did you write a rom-com with a twist?

Jemima: I'm glad you think that.

People have said it has subverted the genre of rom-com.

I am a big rom-com fan.

I like those that are grounded in reality to it I'm not a fan of broad comedy.

A director who is not known for his love -- Christiane: He is the director who did "Elizabeth."

Jemima: Exactly.

Someone who is interested in the truth of the story was to add that layer of authenticity and believability.

I call it a rom-com.

He think that is a family drama, because it definitely has something hopefully serious.

Christiane: It is definitely a family drama, and I want to get back to your family, because you mentioned another interviews that when you left, you left university, you married Imran, you were all jammed together in one apartment with in-laws and the like, and you and Imran were the only love much of that family, you say.

So what did you see around you, assisted and arranged marriages underway?

Jemima: Yeah.

I think the film sort of charge that trajectory as far as what my understanding of what an arranged marriage might be in modern-day Pakistan, also in the West as well.

I was, as you say, was only what they call a love marriage, not arranged marriage, and my ex-husband's entire family history.

We moved in, as is the tradition in Pakistan, with his entire extended family, so I lived with his father, three sisters, their husbands, all of us living in this one big family house, and so I got to see how arranged marriages worked in real life.

I also saw the children grow up and then have arranged marriages themselves when they reached their 20's, and I was kind of involved in that office.

I was involved in the committee to select the suitable spouse or suggest.

It becomes known as assistive marriage, it is more about an introduction.

And what I have realized throughout this period is that some of those arranged or assisted marriages, based around the idea of consent, it is very romantic and based on a really deep love.

You don't start with love, you end with love.

You expect it to a simmer and then boiled to you don't fall into love, you walk into love, and it is sort of a idea.

-- a different idea.

When I came back to the U.S., some of my friends were thinking about having kids, in their early 30's, wanting to look for a suitable father for those Eldred, and we -- those children, and we would have a conversation about what would happen if you were to take purely a love at first sight, the chemistry, that component out of the story, who would your parents or even your friends choose for you, and what might that person be like, and what it work?

And I thought, gosh, what would happen now if I did not have my back story and I let someone choose for me?

That is where Lily James' story gets to after following the jury of her best childhood friend who is having -- journey of her best childhood friend who is having an arranged marriage.

Christiane: That leads me to play the first clip we have.

This is Lily James' character talking to Kaz about all this over a game of ping-pong back in London.

Let's play it.

>> What about love?

>> It is just a way of getting there.

You don't have to start with love and end with love.

You grow to love the person you are with.

>> You know your friends are not making you do this, you know?

>> I know.

>> Do you know what the U.K. divorce rate is?

>> 50%?

>> 55%.

Guess what it is for arranged marriages?

6%.

Boom!

Christiane: She is an English girl with her English eccentric mother living next to an English-Pakistani family.

What were you saying about the vision, the lens, or whatever people talk about right now on these issues?

Jemima: I think it is very easy to be, from a sort of Western viewpoint, quite distasteful about the idea of arranged marriage, whilst we also are sometimes letting algorithms randomly said blocked -- selectmen for us -- Christiane: On a dating app.

Jemima: Yes, and who is to say one is right and one is wrong?

I went in with those preconceptions when I first went to Pakistan.

I thought it was a mid-evil swap that has no place in the common age, and I came away thinking, there is something to this, and there are some very happy arranged marriages I have seen, and we tend to have a somewhat blanketed idea where even some of the mainstream films, the arranged manager candidates are suboptimal and are the -- arranged marriage candidates are suboptimal and are often the butt of the joke.

I wrote this film from the perspective of a common lament from friends I have in Pakistan, who, how they feel they are depicted in the West, that mainstream Western TV and films, whether it is a series like "homeland" or "Zero Dark 30," it is the Muslim people who are the terrorists or somehow backwards.

So we don't have any terrorists in our rom-com, and that is why I wanted to do something a bit surprising, because when you look at the news, you know, about Pakistan, it is often seen as a scary, dangerous place, and scary, dangerous things, as we know, do happen there.

But there is another side of Pakistan, and that is the Pakistan I experienced, which is a fun, colorful, has been will place, and I wanted to make a film but celebrated that, that displayed this beautiful, old architecture, the music, the colors, the costumes, the, you know, and the music was actually very special to me in particular.

Christiane: It certainly hit a major nerve.

From what I gather, from police to whenever you -- release to whenever you can measure it, it was the biggest grossing English-made film, when it was made, released earlier this year in the U.K., and now it is going to be released in the United States.

But you've gotten lots of lovely, and free from the community.

Here is one.

I stayed up all night with my parents having the most sobering conversation about their arranged marriage back in the 1990's in Pakistan.

The border was broken and through the generational divide, it was love that liberated us.

Another says the story is not to showing a British Pakistani family, but it is relatable to every salvation community.

-- South-Asian community can a side not seen.

This is a movie about family, bonds, and relationships.

Were you worried, were you fearful, was the company fearful that somehow this would miss the mark?

Jemima: I mean, if it had, and if British Asians or Pakistanis in Pakistan and India had not reacted positively to the film, regardless of the box office, generally I would've considered it a failure.

But we have been so lucky, and I feel so touched by the unbelievable outpouring of love for this film, particularly from the British Asian community.

I did say it was my love letter to Pakistan but also to Asia and South Asian talent.

We have had so many measures just -- messages like that from social media, where it has helped to have conversations for families in a different generation, and I feel incredibly heartened and touched by those messages.

Christiane: In the United States, you have said, you know, because of the stereotype, the Islamophobia since 9/11, how do you talk about in America?

Jemima: I understand the fear after 9/11 to do obviously there is a fear around Islam and Muslims, but that is why I wanted to make this film, make a film where it is very much not about the baddies but reflects the absolute majority of most of Muslims in the world today.

And I hope that it will resonate in kind of mainstream white America, but I don't know.

Christiane: That is interesting.

It probably will.

There is a huge community there.

There is a huge community in Canada.

This may land at the right time, like it did here.

Interestingly, I have heard that this year, between Hollywood and all the other production centers, some 36 rom-coms are being released.

The genre is getting a surge.

Jemima: Yeah.

It is obviously a very diverse cast and very diverse behind the camera times.

-- teams .

Every single department had Pakistanis for British Pakistanis in it, a South Asian director.

I do think things are really changing in terms of what gets changed and what we see you -- made and what we see on our screens for there has been a massive shift.

Christiane: Like you said, it changes people's neural pathways.

So I'm going to play another clip that we have, which actually this time it is in Pakistan.

[overlapping chatter] >> OK, question.

What did you think about real life?

>> It is great.

Please, don't say that on camera, come on.

>> And I should just tell you what of it.

>> Well, in Pakistan, we really like to draw out the wedding celebrations, it is over three days.

The first is tonight, kind of like a stag and ah hen.

The groom is not stripped naked and tied to a lamppost for the next day is the actual marriage, then the main thing, you enjoy your first night together.

>> What if you haven't enjoyed your first night together?

No,?

>> No comment.

Christiane: How much were you able to shoot in Pakistan, and have you been able to show it in Pakistan?

Jemima: It was COVID when we were shooting, so we could not actually travel there.

That was the second unit.

I'm sure you have interviewed this fantastic document or a maker and a good friend who stepped in and oversaw the Pakistan shoot for us and did all of those scenes.

Christiane: So it is not CGI but real -- Jemima: It was a bit of magic of cinema, but those scenes are shot there, we had to green screen the actors, use body doubles, we did all sorts.

All the architecture you see is Pakistan.

And then comics ordinarily, we managed -- and then, extraordinarily, we managed to create a Pakistan style house, courtyard in London, and amazingly, this incredible singer who placed himself in the film and is pretty much the biggest singer in South Asia, came and acted as himself, because he was in London, even though he is based in Pakistan.

We had this wonderful scene, and honestly, I defy lahoris to watch it and tell me whether it was Lahore or London.

Christiane: I'm not going to do a spoiler alert about who ends up with who, but what is next for Jemima Khan?

Jemima: Well, I have got two document rays coming out this year, and I hope to write something again, 2054.

[Laughter] Jemima: that's how long it takes.

Christiane: No, you've got it done.

It will take less than two years.

Thank you so much.

The film is excellent, and it comes out May 5.

From rewriting cultural assumptions about love to the cutting edge science of new life, questions about having children to the -- took the writer Emily Witt to the limits of reproductive research.

In her latest piece for "the New Yorker," Witt reveals her discovery and explains to Michel Martin how a few biotech startups could be about to change the game.

Michel: Thanks, Christiane.

Emily Witt, thank you for talking with us today.

Emily: It is great to be here.

Michel: Before we get into your article, "the future of fertility, I want to get into your book, critically acclaimed, certainly made a lot of waves, you explore sex and desire in the age of the Internet.

Is there a line between that work and this latest report on fertility?

Emily: I think there really is, because that book was about examining three major challenges, one of which was people getting married much later or not at all, waiting longer to kind of settle down in the traditional sense, if they ever did, and it was about changes in technology and also changing the idea of what a family is and what a relationship is, a broader spectrum of identity and practices and exploring all that.

I think this does fit in, because it is very tied to the new timeline that many of us live under, and also new ideas of a family especially, I think.

Michel: It is my understanding that it really stemmed from your own personal question about some of these issues.

What were some of those questions, and do you still have them?

Emily: Yeah.

So I started writing that book when I turn 30, and this kind of, you know, my parents have been married for more than 40 years, and the relationship that they have and the traditional family that I grew up in seemed very elusive to me, and I was not sure if it was some kind of personal failing or some kind of structural change, but I noticed many people around me in a similar situation and demographic changes that reflected that many people were going through this at the same time.

And in the end, I spent much of my 30's in relationships, but now I am ready to come and I am single again.

And, you know, the book was, in many ways, about trying to figure out what was going on in my own life.

Michel: So in the future of fertility, the piece published in "the New Yorker," you profile new biotech startup firms repressing -- you talk about reproducing human cells without ovaries.

What exactly are they doing, so you can explain, so all of us can get it, and how did the research overlap?

Emily: In the past 10 or 15 years, there has been major advances in stem cell technology, which means that you can use the cell of your own body, skin cell or blood cell, turn back into a cell that has a potential to be any other kind of cell in the body, and that has been used to study cardiac problems, pancreatic problems, all kinds of things, but one kind of cell they might make is in egg cell or spur himself that might help people with fertility issues.

So I focused on two companies, one is trying to make a stem cell, and big sale, and the other is trying to create basically the ovarian environment in which an Excel matures.

So that an immature Excel can be taken from the human body and put in this environment which would kind of mimic the process of IVF but hopefully be a little less invasive and try.

Michel: There were major breakthroughs before your piece was published.

Can you tell us what they were and why they are important?

Emily: Yeah, so they have achieved this in mice but not with humans yet, and right before I went to press, one company conception managed to bring the human big sale to the -- egg cell, it is called a primary follicle, ready to progress into a mature egg cell.

That was an advancement that showed the technology has a lot of progress -- promise.

Another company is creating a lab made, ovarian environment using lab made cells, had a similar breakthrough creating that environment and published a paper about that.

Michel: There are so many dimensions to this.

There's the question of what this could potentially achieve for people, so let's talk about that first.

Why is this something that is appealing to people, not just scientists as a thought exercise -- can we do this?

But how this has a potential to do for humanity, for want of a better way to put it.

Emily: First, it would be really useful to couples suffering from infertility that want to have a genetically related child, especially egg cells in particular are kind of scarce and can be difficult to mature and grow and extract from the human body, so that is one, you know, couples suffering from traditional fertility issues.

But one area I was particularly issued in, is female reproductive longevity.

As we all know, women have a shorter reproductive lifespan than men do.

They are born with all the eggs they are going to have come and by the time they are in their early to mid 40's, those eggs are no longer viable for reproduction.

We are at a time where we are living longer, we start relationships later.

That is a big burden for a lot of women to try to fit, you know, their career, their relationship, their childbearing, all, you know, before the end of their 30's.

So I think there is a real desire to prolong that timeline a little bit, which can have really massive repercussions.

And then the third demographic that this might affect our same-sex couples that would like to have a genetic child.

So conception, the company that is working on making the human egg cell, two of its cofounders are gay men, and using that technology, it is possible that I cell -- a cell taken from a male donor, using this technology, could be turned into an egg cell with two X chromosomes.

That is part of the premise, too.

Michel: Let's talk about the concerns that have been raised about this kind of work.

Let's start with the safety concerns.

Are there any?

Emily: There are huge safety questions.

This is human life.

It is not even pharmaceutical, it is human life.

Yeah.

They would have to prove, you know, assuming they accomplish this, they will have to do animal studies across multiple generations, to ensure that, you know, the genetic and printing is intact, that there is no inherited diseases that only manifest a couple generations down the line.

And then there would need to be clinical trials of humans, too.

And, of course, nobody would be confident about doing this unless they felt safe, as big as the declaration -- desperation is on the people suffering from infertility.

Michel: There are broader social concerns.

One is, and which I am glad you raised in your piece, that, you know, the research into women's, you know, fertility overall or women's health overall, can we just say it, has not really been a priority of the scientific establishment, ever?

Ever!

One of the scientists whom you interviewed said, hey, can we figure out some of the things that affect women's health?

Could that be a higher priority?

Emily: Yeah.

So, you know, there's very little understanding of the causes of infertility beyond the biological timeline.

Scientists don't really understand, first of all, why menopause happens, what, you know, triggers the timeline of it, why it starts, why there is such a large window, you know, it could happen to a woman in her mid-30's or it could happen to you when you are 50.

Nobody really understands why or the effect of ovarian aging on aging and the rest of your body.

Nobody really -- one thing I learned in this article that was really interesting to me is that humans are pretty unique among mammals in that their ovaries a basically more than twice as fast as the other organs in the body -- age basically more than twice as fast as other organs in their body.

Chimpanzees can reproduce almost to the end of their life.

It is this kind of black box.

Science quite does not understand.

The argument is that, yeah, if we can better understand that process, there might be less kind of high intervention way of treating infertility, or at least prolonging reproduction longevity.

Michel: And then there is the tension that you describe in your piece between, you know, how these biotech startups share their information with the world versus traditional kind of academic, scientific research.

Could you talk a little bit about that?

I think that intersects with the core safety concerns and kind of the broader social concerns that other folks might want to weigh in on.

Could you talk a little but about that?

Emily: Yeah.

So this technology involves the creation of human embryos, and there's limited federal funding into that research.

There's restrictions.

And that means that most of the money can come from the private sector or from states, but it means that biotech in the private sector has a research and doing the research -- has an advantage over doing the research against academic channels.

The worry is that it might, perhaps, you know, some of the basic science, and academic research working at a slower pace might be able to achieve more thoroughly.

Michel: How do you think that this also intersects with the intense debate going on right now about abortion access?

You know, primarily in the United States, I mean, it is such an interesting moment, because you cannot help but notice in the United States, there is a major political push to restrict abortion access.

How do you think this research intersects with the outcome of this debate that we are having over access to abortion?

Emily: Yeah.

I mean, unfortunately, in the United States, pretty much any research that has to do with pregnancies, embryos, fetal tissue is extremely polarized and politicized.

And that means that this technology likely, even if they are able to achieve it, one legal scholar told me that she expects it will be more likely to be approved or tested in, for example, the U.K. before the U.S. because of our polarized political environment.

On the one hand, you have a lot of people suffering from infertility, that want to have children.

On the other hand, you have obstacles to scientific research that are rooted in a moral debate about conception and beginning of life and all of that.

Michel: Some of the researchers in your piece fear that this research, let's call it IVG research, VG stands for in vitro Genesis.

Returning to the idea that genetic connection is essential for families.

Emily: It raises the question around, why is genetic connection so important that you would go to such extremes to achieve it?

For some people, that might seem self-explanatory, for others, I don't know, is it worth it?

You know, LGBTQ families in particular have fought for a couple of generations now for legal recognition of a social relationship with their child that is as meaningful and important and deserves as much legal recognition as a genetic one.

And, yeah, so all of these questions will be coming up if this comes real.

Michel: if and when IVG becomes available to the public, you have to assume it will be expensive.

In vitro is expensive.

Is this a concern that this kind of further, I don't know, kind of widens the gap here between the haves and the have-nots?

This is yet another thing that, you know, if you delay childbearing, then this becomes the privilege of the few as opposed to something that human beings be able to do.

Emily: Yeah.

That is absolutely a concern.

Already assisted reproductive technologies, there is lack of access to it.

It is often not covered by insurance, and even if it is covered by insurance, it still can be very expensive.

So this would almost certainly fall under that inequality.

And there is another question that has been brought up, which is that if you have, you know, kind of unlimited supply of egg cells and could make more embryos, THthen it is also easir to do genetic reflection on those embryos, so, you know, people might try to optimize their health co outcomes for, yu know, any kind, and it might have a divide where you have one population trying to create these extremely healthy children and another part that might not even have access to contraception, terminate a pregnancy that is unwanted.

So, you know, there's a lot of questions we will have to ask about what this means, who has access, what it offers to the people who have access.

Michel: And who gets to have a say in that, you know, what process is thereby which the public gets to have its say about this and express its values around this?

Emily: Yeah.

I mean, it will be, you know, I think we have a lot of historical precedents to go on.

Contraception, you know, access is so uneven, limited, people who want it cannot get it, in some places is covered by insurance, and others don't.

It is an extremely polarized question, and I can only imagine this will be similarly polarized, and that, you know, there will be kind of a feminist, likely, I assume, a sort of feminist articulation of what it would mean to have reproductive freedom in this context as well.

Michel: Before I let you go, another question that a Forex -- that affects a lot of us is climate.

There are those that argue that, you know, a lower population does benefit the planet.

They feel that overall, this emphasis on maintaining population, increasing population is the wrong direction to take, given the status of the planet.

What are your thoughts about that?

Emily: Yeah.

I do have thoughts about that.

I mean, overall, the population of the planet is still growing and is expected to grow at least toward the latter end of the century, but when you look at many countries, including the U.S., their fertility rate is a little bit slower, where the decline of people having children in their 20's has not been made up by an increase in people having children in their 30's.

I guess I would say that I don't think this is some kind of pro Nadalist push --pro-natalist push, where you are pushing people to have children they don't want to have.

These are people who are wanting even one child, you know, and I think most of us who agree that having a child, for people that want it we should do everything , possible for those people to have a child.

The population question, you know, I don't, the way that the world has been trending, the United States, many countries in the world now, people just don't want to have a lot of kids, so I don't think we really need to worry about how this would affect the kind of macro trend of population stabilization, really.

Michel: Emily Witt, thank you so much for talking with us today.

Emily: Yeah, thank you.

Christiane: That is it for our program tonight.

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Thank you for watching "Amanpour and Company," and join us again next week.

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