>> good evening from los angeles. first a conversation with glenn cohen. he is at the forefront of ethical answers of life and death questions. as well as the first world responsibility of epidemics like ebola. then we will turn to a conversation with two-time tony winner, savion glover. he made his name on broadway. we're glad you could join us. those conversations coming up right now.

>> the california endowment. help happens in neighborhoods. learn more. >> and by contributions to your pbs station from viewers like you. thank you.

>> who gets the established protocol for dealing with epidemics and what should be done about the explosive use of prescription opiates. those are questions with no simple answers. glenn cohen is the author of an upcoming book. he is also the director of the center for health law policy o biotechnology at harvard. thanks for coming on to this program. let me start with your assessment of how this ebola crisis has been handled to date. >> so i think the general sense of people who work in public health is that it has not been a very strong handling of it. there were about 20 ebola outbreaks since 1976. it was predictable that it was coming. august for the who to declare a

public health emergency and only more recently has issued a road map. many people feel this could have been contained more quickly. one way would be to build more capacity for health care in these countries. >> how could you predict an outbreak of ebola. >> there is a predictable pattern at which every several years you will have an index case like this. to go from index to outbreak really depends on how you manage it and handle it. >> you say we? >> the grand jury is on my side. i think what i'm talking about here is both the international community and many of these are actual countries. right now the who has predicted we're -- >> you should say the world health organization. >> who is a u.n. body.

they don't have complete control over the situation but they have predicted that western and wealthier countries will have to invest about $500 million at this stage to help reduce the spread of this outbreak. they could have probably spent a lot less a lot sooner just to build infection control, better training. there are less than 150 doctors in serialion to get what we view in the public health community as acceptable doctor to patient ratio. >> not always easy, but i suspect this money will come quickly and easily if for no other reason that countries don't want this to spread inside of their borders. >> part of what's interesting here is if you go to the developing world and i lived there for a period of my life. you see all of these deaths from neglected diseases.

for the most part, although there are good ssamaritans, we don't see the same public health cry. we are worried that it's coming to our territory. we have seen americans become infected with it. i wish that we were motivated to cure infect shs diarrhea. >> i think they have done a pretty good job. my main critiques have to do with communication. one of the things we have learned is many of the techniques have been responsible. the other thing is it is more generally encouraging trust to the public health system. that's easier said than done. we can say that is something that i wish he had done better. >> let me get now to some of the ethical questions which fascinate me about what you do when there is an experimental drug that has shown at least in

the lab to work. how do you decide who gets those drugs, who doesn't get those drugs. the short and skinny is that there were a few folk in the west who got access to a drug and it took a minute for that drug to make its way to africa. how do you make decisions number one, whether you should offer up an experimental drug and how do you decide who gets to use that drug? >> sure. so the usual course to get a drug approved in the u.s. is we run animal trials to make sure it's safe and effective in animals and have good data to be sure it's going to work. phase one looking at safety, phase two, looking at efficacy and phase three, looking at dosage and side effects profile. when you have an outbreak of something like this and a desperate need, often you have a question of whether you're going to skip steps. this happens with terminally ill

patients with cancer who want something that is experimental. there is something called a small trial to run to study it. here we have gone through a different mechanism. what happened to the drug, z-map, it appears as though samaritan's purse, which is a missionary organization, i think run by one of billy graham's sons, they called and said we have somebody who has contracted this. can you tell me who is working on a therapeutic. and they pointed them to this company, the map company, and from there it's a little unclear what happened. they decided to make this available even though before the american health workers were given this, it had not been given to a single human being. we still do not know if it was effective or not. it is too small of a number of people to determine if that works or not. >> do we label that as unethical

or label that as these two patients who were willing to take a risk and it happened to work? is it a good roll of the dice on the one hand or unethical on the other hand. >> let me separate the two issues. one is the consent process and the other is if these two patients should have been the ones given this incredibly scare resource. the patients were given information about their needs and the risks involved. many of them, this strain of ebola has 50 to 60% fatality rate. i think it was totally acceptable for them to evaluate that risk and realize they want to try it. we still don't know whether the drug made a difference. it could have been the excellent care and monitoring in an american hospital. so my sense there is about giving information, about empowering patients and especially in a case like this where it's very likely fatal and

you don't have any substitutes it does not seem unethical to give patients that choice. imagine we are talking about something like a kidney, which is still scarce but we know how it works. ordinarily you wouldn't want first come first serve to be the way you allocate something that scarce because people with more resources, they know who to ask, they're the ones to get it first and that seems unfair. instead what we like to do is first we give priority to health care workers. the reason we do that is two-fold. first we think it's a matter of justice. these people put themselves at risk for ebola in particular. we need to give to them as a matter of fairness. and there is a second reason. we need to do this because we want to make sure that doctors are willing to risk their lives and we need to make sure it was favorable to them to go ahead and do this and to know they are going to be taken care of.

so health care workers first. then after that you usually want to do a mix of what we call best outcomes. the people who we think will have the largest chance of success based on age, race, and progression of disease. if there is someone who is very sick, and someone a little bit sick, sickest first. with ebola, everyone who gets it is very sick. there were so few doses with this particular drug that it is unknown whether we could have a standardized system. >> we could have give on the health care workers in africa. >> we also have to learn about how this is working and whether it's working, right? in terms of getting it approved or in terms of being able to improve the product, there is a question of whether this is the kind of drug that could have been easily administered in a nigerian hospital or whether the

monitoring we have in the u.s. increased the chance of a good outcome and allowed us to learn better. that is an extra complication. your sense that we have contained it? >> i do think that now the decision makers and funders understand what the stakes are and my guess is we're going to have a major smith. glaxo-smithkline is working on a vaccine. vaccines are very hard to test whether they work or not. the resources are starting to be poured in, i just wish they had been poured in in december not august. >> let me ask you a quick question about these opiates and the fact that heroin is another issue, another scourge on our society. once again the most famous case of late, i have seen a couple of

governors who made this an issue in major addresses. your sense of whether we are entering into a phase where we will have to put the issue of heroin back on the dockett to get under control? >> the new face of heroin users are 90% white, mostly young. the average age is 23. the painkillers themselves, the overdoses from them are greater than the overdoses of almost all ill illicit drugs. these are a serious public health problem. >> glen cohen, good to have you on the program. coming up, tony winner savion glover. stay with us. >> try this. tap legend gregory hines calls savion glover probably the best

tap dancer that ever lived. he is a two-time tony winner. he is now working with a new generation of dancers to insure that tap continues. let's take a look at savion doing his thing. >> thank you so much for being on this program. i don't want to embarrass you but i was reading my research and i didn't realize you had turned 40. >> yeah, i did that. i did that. >> you are headed in the right direction. for those of us who have been loving you and following you for

so many years, time just moves on. >> i'm happy to be a part of a tradition that keeps me physically fit and also looking rather young. >> you are both that. you are physically fit. how do you process having focused almost exclusively on this one thing since you were a baby? since you were a kid? >> man, this is my life. you know? at a very early age, i was introduced to some men and women who had dedicated their lives to this art form. it's my proud privilege to now dedicate my life to them and to the art form. so i have no choice, man. this is all i want to do.

i am thankful every moment and opportunity i get to share the information and hopefully i can continue on. >> that statement from gregory hines, god rest his soul. i miss and love gregory. his brother maurice was here. gregory labeled you the best tap dancer that ever lived. what do you make of that tradition? we have lost so many of the greats. nicholas brothers are gone, gregory is gone. what do you make of -- what is the state of the tradition? >> the state of the tradition? oh man, let me see. >> yeah. all me a traditionalist, but i am sort of -- i'm more dedicated to the men than i am to the tradition or to the art.

i am dedicated to jimmy, lon, as far as i'm concerned, as long as i continue to develop as a dancer and maintain my commitment to them. now to the general public and to people who tap dance, there is a lot going on. my approach is different than the average cat because maybe they want to, you know, be in movies or do things like that. and they may have to sacrifice their integrity to appear in

certain places or venues. i haven't reached that point and i hope i hope there is a gallon of milk in my refrigerator before i have to sacrifice my integrity for the sake of appearing somewhere. i have issues. i have my opinions of what i see as far as tap dancing and the direction that some of the kids are going in. but hey, some people like lebron. i like michael jordan. >> i take your point. i get it loud and clear that you are committed and dedicated to these men. >> yeah. >> how do you hope you are expressing that commitment? how does that commitment get expressed through your art? does that make sense? >> well, i hope that when people see me, they see the lineage. i hope that when they see me,

they see my ancestors. i hope that when they hear me, they hear the musicality. i hope that when they visualize me, they hear the stories of everything that i am and everything that contributors have dedicated theirat@@ lives e in reference to expression. so, i am just a reflection, hopefully i can continue to be that reflection of so many great contributors, not only through tap dancing but, through literary work, through sports. through economics. through engineering. just contributors. those who are a part of just positive contribution. hopefully i can be a vessel in that area. >> this might be a silly question. i'm going to ask it anyway so

it's not the first or the last silly question. at this point given how well you do this and how long you have done it, is savion glover still getting better or have you reached an apex of your gift. >> mr. smiley, i hope -- i hope to continue my life of wine. red wine. i want to stay corked. when you pour it out, it's velvet. >> yeah. >> so, but, i met -- i was just talking about this. i met george hiltner when he was 81. i met these cats when they were like 70 and they go on to 89, 90. the dance, tap dance, it -- we are different than ballet dancers or modern dancers

because they feet get all -- >> jacked up. >> yeah. but you know, the dance, it's like musicians, you know what i mean? we hear mccoy who is 80 something or whatever. rotunda. it's just amazing. i still look at videos of these cats and still trying to get it. and these are videos of them when they are 60, 70, 80. so i hope that i can reach that point when i'm 80. god willing, 90 when you just continue to get better. and i say this because i have witnessed this. >> yeah. i want to go back to a question i asked earlier about having done this for so long. was there ever a point since you were knee high to a pup, i guess. >> uh-huh. >> was there ever a moment where you thought about either walking away or taking a break?

i asked that because you said earlier this is your life. >> right. >> and yet the flip side of that is that when you focus so laser like on one thing, there is always the chance that you will get burned out. you never wrestled with burn out or wanting to take a break? never? >> no sir. >> never? >> not that i can remember. only, you know, i took a break when the knicks traded patrick ewing, i took a break. i took a break for about a week. >> right. >> i had to kind of take that in. >> yeah, yeah. >> wpno, man. >> have you forgiven the knicks for that yet? >> i have not. i have transferred my loyalty. i had been a knicks fan up until that point. i couldn't understand that. so i had to take a little break from --

"q8y8y8y&n dedicated to the man. you were a patrick fan thr. you with working how time flies. now you with working with and teaching other kids how to do this. i assume there must be some kind of joy in that for you? >> it's wonderful. the thing that i'm most happy with at this point is my approach to teaching is less physical and more towards the efforts of making sure that they are mentally prepared. also to carry out the stories and the legacy and know who these great contributors are.

and in my school, we don't even begin to tap dance until about six to eight months later because we try to establish an identity that the students may be able to relate to. >> wow. >> that will allow them to better express themselves versus tap dance. everybody can tap dance if they choose to, but it's another thing to be able to express yourself through the dance. that's what i'm about. >> i close on that note. since you said everybody can tpb dance. you may have heard that i signed up as a contestant on a new show. >> let's pray. let's have a moment. >> yeah, yeah, yeah. i'm going to try to do this dancing with the stars thing. any advice that you want to pass

on to me? >> just pray. just stay prayerful, brother. >> i think that is a ringing endorsement from my friend savion glover. >> you got it man. i'm going to give you my number. >> i'll holler at you. once you stop laughing, that is. anyway, i love savion glover and i always have since the very first time i saw him. i have been a huge fan. every race of people ought to be judged by the best they have been able to produce. where our art is concerned, savion is one of the best and i celebrate that. glad to have you on the program. >> happy to be here. >> that's our show for tonight. as always, keep the faith. >> for more information on today's show, visit tavis smiley at pbs.org.

>> hi, i'm tavis smiley. join me next time for a conversation with rory kennedy and two time grammy winner, kem. that's next time. see you then. >> the california endowment. help happens in neighborhoods. learn more. and by contributions to your pbs station from viewers like you. thank you.

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