The common belief that the decline in infectious disease deaths is due to modern medicine, like antibiotics and vaccines, is incorrect. The vast majority of the decline, particularly in the early 19th and 20th centuries, preceded these medical ideas. Three key developments drove the earlier progress: 1. The rise of robust public health infrastructure, including engineered sanitation and sewer systems, protected municipal water supplies with filtration and chlorination, systematic garbage collection, early measures to control water and industrial air pollution, food safety regulations (e.g., meat inspection), and vector control (e.g., mosquito reduction). 2. Profound improvements in personal and socioeconomic well-being, such as vastly improved nutrition and increased dietary diversity, rising wages, less crowded housing with better ventilation (which increased exposure to sunlight and thus vitamin D production), the enactment of protective child and adult labor laws, public education, and greater public personal hygiene. 3. The abandonment of harmful medical practices, including treatments with mercury, arsenic, and strychnine, bloodletting and purging, and the “hot regimen,” cleared the way for more supportive care. Data strongly support the pivotal role of public health infrastructure. Research indicates that nearly 90% of the decline in infectious disease mortality among American children occurred between 1900 and 1940, a period before the widespread availability of antibiotics and most vaccines. A parallel, even steeper decline—over 98%—was observed in England and Wales, underscoring that this was a widespread phenomenon driven by societal factors rather than specific medical interventions (and in fact far fewer medical interventions). “...nearly 90% of the decline in infectious disease mortality among US children occurred [from 1900] before 1940, when few antibiotics or vaccines were available.” [“Annual Summary of Vital Statistics: Trends in the Health of Americans During the 20th Century,” Pediatrics, December 2000, pp. 1307-1317.]