US & Iran Reach Ceasefire...For Now

[0:00] It's Wednesday, April 8th. We have a ceasefire on a few conditions. We start here. [0:08] The U.S. and Iran say they've agreed to a two-week pause in fighting. [0:12] There is a lot to be worked out in the coming days. [0:15] But each side is claiming victory here, so what are they actually agreeing to? [0:20] Meanwhile, the White House is actively campaigning for a controversial foreign leader. [0:24] We have got to get Viktor Orban re-elected as prime minister of Hungary, don't we? [0:29] Why J.D. Vance showed up in Hungary ahead of a crucial election and, when in doubt, cut it out? [0:35] As the limb salvage director here, this is what I do on a daily basis. [0:39] That's what you're, it's limb salvage director. [0:41] That's right. [0:41] A rise in amputations has injected new urgency into the diabetes debate. [0:48] From ABC News, this is Start Here. I'm Brad Milkey. [0:52] The promise from President Trump to Iran was simple. [1:02] Allow ships to freely pass through the Strait of Hormuz by 8 p.m. Eastern Time Tuesday or face crippling attacks to your power and transportation infrastructure. [1:12] The entire country could be taken out in one night, and that night might be tomorrow night. [1:17] Some had already questioned whether these sorts of targets could constitute a war crime. [1:21] Others asked whether Trump was just posturing to speed along a diplomatic solution. [1:25] Critics predicted a Taco Tuesday, referencing the acronym that Trump always chickens out. [1:30] But yesterday, as this deadline drew nearer, President Trump only became more dire. [1:36] In a social media message, he said, quote, [1:38] A whole civilization will die tonight, never to be brought back again. [1:43] I don't want that to happen, but it probably will, end quote. [1:47] Four o'clock came and went. [1:49] American embassies were under shelter-in-place orders. [1:52] Five o'clock passed, six. [1:53] Then, less than 90 minutes before his own self-imposed deadline, President Trump posted on his social media platform that there would be no attack for now. [2:03] A cease-fire deal, he said, has been reached. [2:06] This morning, the entire Middle East, the entire world, is trying to figure out what it all means. [2:11] So with that, let's take you straight to the White House. [2:13] ABC's chief White House correspondent, Mary Bruce, is back with us this morning. [2:17] Mary, this wasn't just a threat. [2:19] This, at one point yesterday, started coming across like a promise. [2:22] The president was publicizing strike windows, lists of targets. [2:26] What happened? [2:27] And planning was underway to launch additional attacks. [2:30] But then, just an hour and before the president's self-imposed deadline, [2:34] Trump taking to social media, saying that he would agree to suspend attacks on Iran for two weeks, [2:38] saying this would be a double-sided cease-fire, but critically that Iran would have to agree to the, quote, [2:44] complete, immediate, and safe opening of the Strait of Hormuz. [2:48] About an hour later, Iran announced that they were on board. [2:52] The president is suggesting that negotiations are making headway. [2:55] He says this two-week period will allow for an agreement to be, quote, finalized and consummated. [3:01] But, Brad, the reality is that while this cease-fire now buys time to negotiate, [3:05] there is a lot to be worked out in the coming days. [3:09] Yeah, so what happens here, then? [3:10] Like, cease-fire, that means, what, neither side is firing on each other at all? [3:15] There's no drone attacks from Iran? [3:16] Like, has Iran agreed to this? [3:18] Well, Iran, no surprise, is framing this as a victory for their side. [3:22] The Iranian foreign minister framing this as the U.S. accepting their general framework [3:27] of the 10-point proposal that Iran put forward as the basis for negotiations. [3:31] Now, that isn't quite how the U.S. sees things. [3:34] But Iran critically agreeing that for a period of two weeks, they will allow safe passage [3:39] through the Strait of Hormuz. [3:41] The question is, how will they be able to reach any consensus on a broader deal that [3:46] can actually bring this war to a close once and for all? [3:50] Well, right. [3:51] And so Trump had said this was contingent on the Strait of Hormuz reopening. [3:54] Does that mean today? [3:55] Like, none of this matters if ships are not passing through the Strait unmolested by Iran [4:01] now? [4:02] Like, how does that work? [4:03] Brad, I've been told that this cease-fire goes into effect once the Strait is reopened. [4:08] That's what has to happen in order for attacks to be halted. [4:11] And now both sides have agreed, so presumably that is happening in short order. [4:15] This is President Trump being able to say that he's gotten them to come to the table and [4:19] ultimately reopen the Strait of Hormuz. [4:21] And we've seen what that's done to oil markets with its closure over the last several days. [4:26] And remember, this cease-fire was a proposal that was made by Pakistan, which has been [4:29] acting as a go between the two sides, putting forth this idea of a two-week cease-fire contingent [4:35] on the passage of ships through the Strait to allow more time to negotiate. [4:39] This all came together frantically, very quickly, late yesterday afternoon as that clock was [4:44] ticking down to the president's deadline. [4:46] But it does offer this potential off-ramp, or at least it buys additional time to negotiate. [4:52] It hasn't been firmed up yet when the two sides will actually come together, but it [4:57] does seem that that will happen in short order, given that the cease-fire now is just on the [5:01] calendar for two weeks, Brad. [5:03] And lastly, Mary, these threats that made such big headlines in the hours leading up to [5:07] all this, was it all just bluster? [5:10] Like, was it all just posturing? [5:12] And if it was, did that bluster of basically saying, like, a whole civilization will die [5:17] if we don't get what we want? [5:19] I mean, what effect does that have on this war? [5:20] And what effect does that have on the president's own political base? [5:24] Yeah, it's a good question. [5:25] I mean, it's unclear whether that incredibly alarming, apocalyptic warning is what pushed [5:32] Iran to be willing to agree to this cease-fire. [5:35] That's unclear, but certainly one of many remaining questions. [5:38] But the president is taking a lot of heat for this. [5:41] I mean, he was threatening to wipe out a civilization, to target civilian infrastructure, threatening [5:47] to wipe out all of Iran's bridges and power plants. [5:50] Burning, exploding, and never to be used again. [5:53] I mean, complete demolition. [5:55] Even some of the president's staunch allies were saying this goes too far, basically. [6:00] Of course, knocking out civilian infrastructure constitutes a war crime, even though the president [6:04] has said he's not worried about breaking any international law. [6:07] And of course, you have people like Tucker Carlson. [6:11] On every level, it is vile. [6:15] On every level. [6:17] Prominent voices in the president's MAGA base expressing real disgust with the language [6:22] coming from the president and the way he was framing and threatening Iran. [6:27] Right. [6:27] And you and I have talked about how, you know, in some conflicts you get cease-fire agreements [6:30] that are just a few days long. [6:32] It's a very temporary feeling thing. [6:33] Other conflicts have cease-fires that you're like, wow, this is the end of the conflict. [6:37] We're going to see what comes out of all this. [6:39] In the meantime, this is very much just a negotiating period. [6:42] It could be broken, for all we know. [6:44] There are a ton of different contingencies, a ton of different caveats that each side is [6:47] insisting upon. [6:49] We'll see what happens. [6:50] Mary Bruce at the White House right now. [6:51] Thank you. [6:52] Thanks, Brad. [6:52] Next up on Start Here, American allies are welcoming this news of a cease-fire. [7:00] This other political alliance? [7:01] Maybe not so much. [7:03] We're back in a bit. [7:08] In some ways, the U.S. taking on Iran is a continuation of Cold War politics going back [7:13] more than half a century. [7:14] Russia has been one of Iran's biggest patrons. [7:17] They've really helped prop up the regime that the Trump administration now so publicly [7:20] wants to take down. [7:22] Well, yesterday, Vice President J.D. Vance made a last-minute trip to a different foreign [7:26] country. [7:27] Different continent, actually. [7:28] Thank you, Prime Minister, first of all, and thanks to the people of Hungary for welcoming [7:32] me. [7:33] This is a beautiful city. [7:34] He was not just there to meet with a foreign leader and shake hands and talk about statecraft. [7:38] He was actively endorsing the current Prime Minister of Hungary for re-election this [7:43] weekend. [7:43] We have got to get Viktor Orban re-elected as Prime Minister of Hungary, don't we? [7:48] He even helped campaign for Viktor Orban. [7:53] You're fighting for your freedom. [7:55] You're fighting for your sovereignty. [7:57] And I'm here because President Trump and I wish for your success. [8:01] And we are fighting right here with you. [8:03] That is unusual. [8:05] What is even more unusual is that, if anything, Viktor Orban is considered a key tool for the [8:10] Russian government. [8:11] Big moments here implicating a lot of countries. [8:13] ABC's foreign correspondent, Tom Sufi-Burge, has been watching this closely. [8:16] Tom, can you walk us through what Vance was doing yesterday in Hungary? [8:20] Yeah, the vice president's on a two-day visit to Hungary. [8:23] He held a joint press conference with the Hungarian Prime Minister, Viktor Orban, five days before [8:29] this absolutely crucial election. [8:31] It's not just crucial for Hungary. [8:33] It's crucial for Europe. [8:34] It's also important for the Trump administration's, you know, very open policy to endorse and promote [8:42] kind of MAGA-style politics in Europe. [8:45] They're backing far-right movements right across this continent. [8:48] The United States of America is the strongest country in the world. [8:52] And I'm happy to say that they are our allies today. [8:57] But the key thing with Viktor Orban is he is already in power. [9:01] He's kind of the Trump administration's point man in Europe. [9:04] He's the only really significant leader who is very much on side, Trumpian politics, Trumpian [9:11] style. [9:12] And, you know, Jay Vance held a rally with Viktor Orban just before this election and openly [9:19] endorsed him in the most overt way and even got President Trump on his cell phone to also [9:26] offer a message of support and drill down on those key messages like tough on immigration. [9:43] He didn't allow people to storm your country and invade your country like other people have. [9:50] Which is something which has played well for Viktor Orban through the years. [9:53] It's been clear for a long time that Trump clearly sees Orban as an ally. [9:58] But like what is, I guess, why is this such a big deal for Europe and why is this so kind [10:01] of unusual to see this level of camaraderie? [10:05] Yeah, Viktor Orban has been an ally of Donald Trump going back a very long time. [10:09] He endorsed him back in 2016 when Trump won his first presidential election. [10:14] But Viktor Orban speaks the same type of politics as Donald Trump. [10:18] If you look at his stance on immigration and other things, you know, if you look at Europe, [10:23] they've made tremendous mistakes on immigration. [10:25] It's really hurting them very badly. [10:27] He has not made a mistake on immigration. [10:29] But he also has been a thorn in the side of the European Union. [10:33] I mean, he's fighting for his fifth consecutive term in this election. [10:37] He's a right winger, hard on immigration, socially conservative. [10:42] And over the years, over the decades, really, he has gone against the kind of mainstream in [10:49] the European Union. [10:50] I'm the longest serving prime minister of Europe. [10:52] I survived all the prime ministers who attacked us. [10:55] And I'm sure we will survive next year as well. [10:58] So we will manage our conflicts successfully. [11:01] He has, you know, basically curtailed freedom of the press. [11:05] If you listen to the joint press conference between J.D. Vance and Viktor Orban, you heard [11:10] the two questions that came from Hungarian media. [11:12] They were so friendly for Viktor Orban. [11:14] They really set him up on issues exactly he wanted to speak to. [11:17] And that was a sign there. [11:19] But Viktor Orban has always, like, basically, you know, pushed against EU rules in terms [11:24] of democracy, minority rights. [11:28] And, you know, he and the European Union have not only kind of gone at loggerheads on that [11:33] issue, but more recently, really on the war, Russia's war in Ukraine. [11:38] Viktor Orban is a massive, massive friend and supporter of Vladimir Putin. [11:43] He openly, you know, champions the fact that he buys Russian gas and oil. [11:50] That isn't obviously unusual in Europe, historically speaking. [11:53] But he really has basically cultivated a very positive relationship with Vladimir Putin. [12:00] The strategy that the Europeans have followed to support Ukrainians so far has ended, has [12:10] failed. [12:10] This strategy has failed. [12:12] He's the black sheep of the European Union. [12:15] He goes against the other kind of massive wave of support, which the rest of Europe, [12:21] effectively, apart from Slovakia, offer to Ukraine in their defense against Russia. [12:26] But then fair to say, Tom, that the challenge Hungary poses to the rest of Europe, the way [12:30] Hungary has kind of changed the, you know, the world order in that part of the world, is [12:35] almost exactly what Putin would like to see out of Trump in the Western hemisphere, right? [12:39] Of changing that order, of shifting those alliances, that this is almost the relationship he would [12:43] like to have with the Trump White House. [12:46] Undoubtedly. [12:46] I mean, I think, you know, Vladimir Putin has definitely, you know, worked hard and his [12:51] whole government has worked hard to cultivate better relationship with the Trump administration. [12:55] The Trump administration has been open to that. [12:57] And President Trump, generally speaking, has spoken warmly about Vladimir Putin on multiple [13:03] occasions. [13:04] Obviously, you know, Viktor Orban is in the European Union. [13:07] So he does have a vote at the table when it comes to whether to provide financial aid to [13:12] Ukraine. [13:13] So, you know, that is why this election is so critical. [13:17] What really is interesting, though, is that in this, his bid for a fifth consecutive term, [13:23] Viktor Orban is facing his toughest electoral challenge yet. [13:28] His challenger is much younger. [13:30] He's a good looking guy, Peter Magyar. [13:33] He's a fellow conservative. [13:34] And that is the key thing here, because Magyar, the opposition leader, is also tough on immigration [13:40] and socially conservative. [13:42] And those two things are almost essential in Hungary if you're going to win the election. [13:47] What Magyar is attacking Orban on is corruption. [13:51] He's alleging that, you know, Orban and his government over the years has been guilty [13:56] of corruption. [13:57] And Magyar used to be in Orban's own party. [14:02] I think that the TISA will have an overwhelming electoral victory, because even Fidesz voters [14:08] do not want our country to be a Russian puppet state, a colony, an assembly plant instead [14:14] of belonging to Europe. [14:15] And the key thing here is that Magyar has been leading consistently in the opinion polls. [14:20] That said, the media, by and large, is much, much more favourable to Orban. [14:27] Orban has a large degree of control over Hungary's mainstream media. [14:32] And so going into this election, I mean, it's going to be a fascinating, fascinating result [14:37] on Sunday. [14:37] It really does matter for Europe, for Ukraine and Russia's war there, and also for whether [14:48] or not President Trump's stated aim of promoting these far-right parties right across the continent [14:54] is actually going to succeed or not. [14:56] And it's a really interesting dynamic to think, is it a positive thing for Viktor Orban to have [15:03] J.D. Vance, the U.S. vice president, openly endorsing him just before an election or not? [15:08] Right, I was going to say, especially across Europe, you've got a lot of anti-American [15:11] sentiment with this war in Iran, if people see it as unnecessary, even there in Hungary. [15:16] All right, Tom Sufi Burge, thank you so much. [15:18] Thanks, Brad. [15:20] Okay, one more quick break. [15:21] When we come back, diabetes cases are up, but amputations from diabetes are way up. [15:28] One last thing is next. [15:32] And one last thing. [15:35] For years, my colleague Steve Osinsami has been reporting on diabetes. [15:39] It's personal for him. [15:40] My father was a diabetic for most of his life, and he took terrible care of his blood sugar levels. [15:49] He describes coming home one day to the news that his father's condition had gotten beyond [15:53] anything he could imagine. [15:54] It wasn't until I walked into the house that day that my father was finally honest about it, [16:02] because what was happening is he's staring at me in the face and he did not know who I was. [16:06] He only knew who I was when I started talking. [16:09] The diabetes had robbed my father of his sight. [16:14] He was already blind. [16:15] My dad died about two years after that. [16:18] But recently, he says, the world of type 2 diabetes has seen an epidemic, not just of the disease, [16:24] but also an epidemic of amputations. [16:28] What often happens with diabetics is they lose their fingers or usually their lower extremities, [16:35] their toes, their feet. [16:36] When high blood sugar is left unchecked, arteries get clogged and blood vessels get narrow. [16:41] Eventually, they get so weak and frail that extremities can't get enough blood to survive. [16:46] There is this exceptional rise in what's called PAD, peripheral artery disease, [16:52] and the amputations that occur because of that. [16:56] In the next hour after you hear this, 16 Americans will have had amputations because of it, [17:02] which is how Steve met Cynthia Ryan. [17:05] I'm so happy to be able to tell somebody my story. [17:09] We followed the story of Cynthia Ryan. [17:12] She's a 64-year-old retired nurse and grandmother in Memphis, Tennessee. [17:16] People tell me all the time, I ain't going to claim diabetes. [17:21] You ain't got to claim it because they're going to claim you. [17:23] Cynthia learned she had diabetes back in 2001. [17:27] Eventually, she managed to get her blood sugar down, but damage had already been done. [17:31] She'd had two heart attacks, her kidneys were failing. [17:34] Now, a simple toe injury became an emergency. [17:37] It became clear her arteries were not sending enough blood to her feet. [17:41] Her toe was black. [17:43] It was very hard to look at. [17:45] This toe is dead. [17:46] Right. [17:46] She said, Mama, don't say that. [17:48] The nurse and you knew? [17:49] I knew my toe was dead. [17:52] And you feared? [17:53] And I feared it just, it's going to go further. [17:56] She knew she was diabetic, but she wasn't really taking care of her blood sugar levels. [18:01] And now she's in crisis. [18:04] Now, when Steve says crisis, he means crisis. [18:07] When blood flow deteriorates like this, damage to the toe can quickly become damage to the foot or the leg. [18:12] Because of that, the first instinct for many doctors can be to amputate aggressively. [18:17] But some doctors say that instinct has become part of the problem. [18:21] While diabetes cases have risen, amputations have exploded. [18:27] And those amputations are not spread around the country equally. [18:30] What we also saw is that those amputations were more prevalent in black and brown communities. [18:37] Some of this is about health care and medical trends. [18:40] But the other part, many experts say, is systemic. [18:44] It's about access to early prevention, hospital resources. [18:47] It matters where these decisions are happening. [18:49] It's one thing to be in a specialist's appointment. [18:52] It's another thing to be in an emergency room. [18:54] But one thing is clear. [18:56] Amputations are often the first step down a devastating road. [19:00] Movement is life. [19:02] And so just by saving these limbs, you're saving that patient's life. [19:07] Dr. Jacqueline Majors in Memphis told us, of these patients who end up with a major amputation, [19:13] 25% of them are usually dead in a year. [19:17] These patients significantly benefit from an angiogram. [19:21] And that's an intervention where you open up the blood vessels in their legs, [19:26] which can restore flow, heal wounds, and prevent amputations. [19:30] As the limb salvage director here, this is what I do on a daily basis. [19:34] That's what you're, it's limb salvage director. [19:37] That's right. [19:38] Dr. Majors became Cynthia's doctor. [19:40] She was determined to make sure Cynthia only lost that one toe. [19:43] We start off with a small, gentle balloon dilation. [19:49] She actually used a balloon to literally inflate the spaces inside Cynthia's foot [19:54] to get the blood flowing. [19:56] We were there with her during this procedure in Memphis, and it was a success. [20:00] How does the foot feel? [20:01] Foot feels good. [20:03] She woke up from the procedure, and instantly she said that the pain in her foot was less. [20:09] Look how she's walking like you are awesome. [20:12] Oh my goodness, Carol, look. [20:14] Not wobbling. [20:15] You could just tell she felt better because that foot was getting blood flow in a way that [20:21] it wasn't. [20:22] So her next steps will be go see her podiatrist. [20:25] He will set her up for the toe amputation, and then she'll be seeing him and myself afterwards [20:31] to evaluate to make sure we get good wound healing. [20:35] This is where I wish I could tell you Cynthia got her toe amputated and went home happy and [20:39] healthy. [20:40] That's not what happened, though. [20:43] Remember how Steve said some health outcomes can be systemic? [20:45] Well, her family says there was confusion about when she was supposed to get her toe [20:50] removed. [20:51] Instead of that amputation happening within days or a week, it was delayed by weeks. [20:56] Soon, the damage was spreading. [20:58] The doctors decided they had to cut off her foot. [21:02] And so they started with cutting off the whole foot. [21:06] And what often happens in these cases is they determine that that's not enough. [21:12] They had to come back and cut more. [21:14] I think they said she did two or three surgeries, and they were around either above or below [21:23] the knee when Miss Ryan said no more. [21:29] And she died in January of this year. [21:32] That experience rocked everyone associated with Cynthia. [21:36] It rocked Steve. [21:36] Oh, Brad, these are like, you know, because of my own personal story, you know, that news [21:49] hit me. [21:50] But Cynthia's family is determined not to let it happen to others. [21:54] What is your advice for any other family who might be dealing with this? [21:58] Make sure you are able to navigate this and make decisions as you go and not as an emergency. [22:05] These are preventable things that we could have prevented if we had educated ourselves better. [22:13] We can't keep dying as black and brown people from diabetes. [22:18] We can't keep dying like this. [22:21] Just in the last year, new tools have been approved by the FDA that can help avert amputation. [22:26] One of them is a stent that is degradable. [22:30] It's a stent that kind of opens up the blood vessels and it can degrade on its own. [22:36] And another is a removable stent that doctors can put in and pull out later because they [22:41] don't like leaving stents in because they can sometimes fail. [22:45] Cynthia's family says for patients, the message is simple. [22:48] Act now. [22:49] If you have diabetes, get treatment. [22:51] If you're noticing changes to your blood flow, get it checked. [22:54] And hopefully, with these new tools, fewer lives will get cut short. [23:01] That was Steve Osansami there. [23:02] Excuse me. [23:03] Emmy-nominated Steve Osansami. [23:05] Multiple nominations for him yesterday along with several other colleagues. [23:08] Congrats. [23:08] That piece featured last night on ABC News Live Prime. [23:11] You can, of course, check it out today on Hulu, on YouTube, on the ABC News app, wherever [23:15] you stream your news. [23:16] And keep it there throughout the day because there is a lot more to come from the Middle East. [23:20] I'm Brad Milkey. [23:21] I'll see you tomorrow.