Pharmaceuticals do not fall from the sky. Before they are available, they must be developed. This historical framework has three aspects—the past without which we cannot understand the present, and the present which we have tried to make more understandable in all this book’s chapters. And the future? Our crystal ball is a bit opaque. We can extrapolate some of today’s technical developments into the near future, such as the technique of microencapsulation. Other dimensions are more diffi cult to predict, such as the future of US and EU pediatric legislation, which role patient advocacy groups will play in 10 or 20 years, towards which priorities the public opinion will swing during the next decades, and how politicians will channel it. And then there are the truly unknown unknowns, those surprises in science, social environment and any other aspect of life that most of us did not and do not expect (apart from the true prophets, which we are not).