This commentary uses a recent article in the press about the failure of the Gates Foundation's plans to eradicate poliomyelitis in Asia and Africa as a basis for discussing the often limited historical role that vaccines have played in controlling many infectious diseases when compared to increases in living standards. A recent book on the Epidemic Intelligence Service of the Centers for Disease Control and Prevention, USA, is used to illustrate the importance of epidemiological surveillance and public health laboratories in past and present efforts to control infectious diseases. On the basis of these publications, the author discusses and proposes solutions for some of the shortcomings of the Chilean sanitary services demonstrated when dealing with a recent epidemic of more than 26, 000 cases of acute diarrhea in the Northern Chilean city of Antofagasta.