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That's an ambitious goal, and as I mentioned in the Introduction, one that will strike some people as crazy. But I'm convinced that it's possible, and in the rest of this chapter, I want to make the case that we can do it. Getting a vaccine out of the lab and into patients takes four steps--developing it, getting it approved, manufacturing it at high volumes, and delivering it--and we'll look at the opportunities to accelerate the process along the way. We'll look at why it's usually so hard to create and test a vaccine and why it takes so long. What exactly is happening in those five or ten years before it's ready for the market? We'll also explore why scientists were able to move so much faster this time--it's a fascinating story of farsighted planning, dogged research by two heroic scientists, and more than a little luck. Unfortunately, as we've seen with COVID, it's one thing to get a vaccine created and approved. It's another challenge entirely to avoid creating a system of vaccine haves and havenots--to make and distribute enough doses to quickly reach everyone who needs them, including people in low-income countries who have a high risk of getting severely sick. The distribution of COVID vaccines in 2020 and 2021 was, to quote Hans Rosling again, both bad and better. Vaccines reached more people faster than any other vaccination effort ever. They also reached many people in poor countries faster than ever--but not fast enough. So we'll look at ways to distribute vaccines more fairly. <~?~Insert art 026a_Gate_9780593534489_art_r1> <~?~Insert art 026b_Gate_9780593534489_art_r1> These two images are a reminder of how uneven vaccine availability can be. In the U.S. rows of cars lined up at predetermined locations, while people living in more remote