We have come a long way but we are not there yet. We need to capitalize on the wave of recent discoveries across the whole ALS field and prioritize therapeutic targets and programs with the greatest chances of short- or medium-term success. This we will achieve through the support of new research consortia and by exploiting the full potential of our growing core facilities. In parallel, we also need to create the environment in which research projects can be turned into viable, effective therapeutics. This will involve pursuing our successful strategy for bringing together the best and the brightest from academia and industry. It will also require that we help create new resources and tools to smooth the passage to more and better trials. Together with its many partners, Target ALS is now uniquely placed at the fulcrum between discovery and drug development. With support from all concerned, the next five years could bring about the change that ALS patients have so long awaited.