Pfizer’s new Covid pill could spark a fiery ethical debate

This is Bloomberg Opinion Today, a dropping ball of Bloomberg Opinion’s opinions. Sign up here.Today’s Agenda Pfizer’s new Covid pill could [Bloomberg]( Follow Us [Get the newsletter]( This is Bloomberg Opinion Today, a dropping ball of Bloomberg Opinion’s opinions. [Sign up here](. Today’s Agenda - Pfizer’s new Covid pill could [set off an ethical conflict](. - [China is running dry](, and that’s dangerous for its neighbors. - Bloomberg Opinion’s columnists [say]( [some]( [sooth]( about 2022. Who Should Get Pfizer’s Covid Pill First? It’s good news that Paxlovid has [won emergency use approval]( in the United States. But, as Faye Flam points out, Pfizer’s Covid pill could set off a rancorous ethical conflict over [who should get it first](. In trials, Paxlovid cut the risk of hospitalization by 88% among people with several risk factors who took the drug within five days of the onset of Covid symptoms. (Merck’s antiviral pill, molnupiravir, [seems to be]( only around 30% effective in preventing hospitalization.) But it will be a while before there are enough pills for everyone — and while production is being ramped up, expect debate over how to apportion the available supply. As Flam puts it, “If people were mad about unvaccinated patients burdening medical staffs and taking up beds in hospitals, wait for the clamor over who gets the new pill.” Paxlovid would be valuable for people who can’t get the full benefit of vaccines because they have suppressed immune systems. But should these folks have to compete with those who put themselves at risk by willfully skipping vaccines? What about people who got the vaccines but haven’t gotten around to getting the boosters, despite being over 65 or having conditions such as obesity and diabetes? This group could make up the bulk of demand for the new pill. And then there are longer-term conundrums to come when the supply is fully ramped up. If the drug is used too widely, that might increase the chance that the virus develops resistance, as other pathogens have done with pharmaceuticals. That should temper hopes for an easy cure, Flam says. A Drying China Is a Danger to Its Neighbors It isn’t just because of its huge population that China is the world’s largest importer of agricultural goods: The country simply doesn’t have the water to grow enough food. Home to 20% of the world’s people, it has only 7% of the planet’s fresh water. Thousands of rivers have vanished, and other water sources have been despoiled by industrialization. The government spends tens of billions of dollars to divert water from comparatively wet regions to the drought-plagued north, where it’s as dry as in the most arid parts of the Middle East. And the situation is getting worse. This is bad news [for China’s neighbors as well as China itself](. As Hal Brands points out, resource scarcity often leads to political instability — and heightened foreign tensions. If the Communist Party feels pressured by a parched populace, it may be tempted to create distractions by lashing out against international rivals. For countries that share borders with China, the danger is clear and present. Beijing has a tendency to try and solve its resource challenges by bullying and beggaring its neighbors. Giant Chinese dams on the Mekong River have triggered recurring droughts and devastating floods in Southeast Asian countries such as Thailand and Laos. The diversion of rivers in Xinjiang has had devastating downstream effects in Central Asia. Water is also a growing source of tension in the Himalayas, where China plans to dam key waters before they reach India, with which it has history of bitter disputes — including one war, in 1962, and more recent border scrimmages. The thirstier China gets, says Brands, the more geopolitically nasty it will become. Our Oracles Have Spoken Ancient Greeks curious about what the future held had to schlep to the slopes of Mount Parnassus [to consult the high priestess]( of the temple of Apollo. But we’ve got a digital Delphi for you right here. What’s more, unlike the famously cryptic Pythia, our diviners tell it straight. Continuing our series of predictions for 2022, Parisian Lionel Laurent notes that the Euro is about to turn 20 and warns that [its strength will be tested]( by the combination of Covid and cryptocurrencies. Reading the auguries at the other end of the world, Rachel Rosenthal warns that [Singapore’s future as a global financial center]( will depend on its ability to restore a semblance of normalcy, especially in travel and tourism. And from London, Paul J. Davies predicts a busy year for central bankers as [the era of easy money comes to a close](. Click on those links and you can also read a selection of each columnist’s favorite pieces from the year about to close. Further Reading The FAA [shouldn't hinder America’s 5G rollout](. — Bloomberg’s editorial board The effects of [inflation and China’s corporate clampdown]( could play out in unexpected ways next year. — Mohamed A. El-Erian We underestimated inflation in 2021. [Let’s not overestimate it in 2022](. — Romesh Ponnuru Cheap money and the need for growth has [blinded investors to the risks of fintech](. — Ben Ashby New York’s incoming mayor is [doubling down on his law-and-order message](. — Robert A. George Biden can learn from how Trump’s handled Iran: [Sanctions aren’t enough](. — Eli Lake The Internal Revenue Service is [doing a poor job of protecting the data it collects](. — Stephen L. Carter ICYMI [China’s top tech moguls have lost billions](, but one former professor is [going in the opposite direction](. Free economies will account for [only 26% of the global GDP]( in 2050. Record Covid fatalities are [deepening Russia’s demographic crisis](. Peter Thiel is [hiring a disgraced former Austrian chancellor]( as a global strategist Kickers Ghislaine Maxwell’s next prison [will not be a “Camp Cupcake”]( like the one that housed Martha Stewart. It’s been a [bumper year for the discovery of new species](… including some that are [long gone](. Quelle horreur! French moviegoers [must make do without popcorn](. Notes: Please send bubbly or plonk to Bobby Ghosh at aghosh73@bloomberg.net. [Sign up here]( and follow us on [Twitter]( and [Facebook](. Like Bloomberg Opinion Today? [Subscribe to Bloomberg All Access and get much, much more](. You’ll receive our unmatched global news coverage and two in-depth daily newsletters, The Bloomberg Open and The Bloomberg Close. 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