‘The twentieth century and beyond’ describes some of the major successes of modern pharmacology, before looking toward the future. Tuberculosis was a major killer before the discovery of streptomycin and other antibiotics brought the disease under control. The oral contraceptive pill is not a ‘cure’ as such, but it liberated women from a life of childbearing and enabled the 1960s sexual revolution. Ironically, as drug developments make us live longer, we will suffer more from cancer, Alzheimer's disease, and other age–related diseases, but exciting discoveries promise novel treatment options. However, if these prove too expensive for sufferers to afford, they will benefit no one.