Polio Eradication: the final challenge Third, appropriate policies will need to be developed, and internationally agreed, for the duction of wild poliovirus and ensure the global capacity to manage such an event shoulde post-certification era. These policies must be designed to both minimize the risk of reint occur. Consequently, policies will be needed in four areas: polio detection and notification, long-term biocontainment of all poliovirus strains( that is, wild and vaccine strains), polio vaccine stockpiles, and routine immunization(11). The development of these policies will be even more complex than it was for smallpox, for a number of reasons. For example, the very low risk of vaccine-derived polioviruses regaining the capacity to cause outbreaks is now well documented. Furthermore, the risks of international terrorism have substantially affected the willingness of some policy-makers to plan for the discontinuation of routine polio im munization in the near future, regardless of the economic benefits. Because of the complex ity of these issues, ongoing research in this area will be complemented by broad consultation with governments and stakeholders through the World Health Assembly and other forums from 2004 onwards(11). Scaling up the delivery of health services The greatest success of the polio eradication initiative to date has been its capacity to reach virtually every population in the world with a basic health service, regardless of geography, religion, conflict or even the strength of the health system. This experience in scaling up to plement fully the eradication strategies is now one of the most valuable assets of the pro gramme. Perhaps the most frequent, if unfair, criticism of the highly regarded smallpox eradi- cation effort was that it left little infrastructure behind to tackle other diseases. Indeed the ultimate legacy of the polio eradication initiative will depend largely on the extent to which the experience and lessons learnt are used in scaling up the delivery of other health services Figure 4.3 Global action plan for laboratory containment of wild polioviruses, February 2003 8 urveys not started Surveys completed, inventories submittedPolio Eradication: the final challenge 67 Third, appropriate policies will need to be developed, and internationally agreed, for the post-certification era. These policies must be designed to both minimize the risk of reintro￾duction of wild poliovirus and ensure the global capacity to manage such an event should it occur. Consequently, policies will be needed in four areas: polio detection and notification, long-term biocontainment of all poliovirus strains (that is, wild and vaccine strains), polio vaccine stockpiles, and routine immunization (11). The development of these policies will be even more complex than it was for smallpox, for a number of reasons. For example, the very low risk of vaccine-derived polioviruses regaining the capacity to cause outbreaks is now well documented. Furthermore, the risks of international terrorism have substantially affected the willingness of some policy-makers to plan for the discontinuation of routine polio im￾munization in the near future, regardless of the economic benefits. Because of the complex￾ity of these issues, ongoing research in this area will be complemented by broad consultation with governments and stakeholders through the World Health Assembly and other forums from 2004 onwards (11). Scaling up the delivery of health services The greatest success of the polio eradication initiative to date has been its capacity to reach virtually every population in the world with a basic health service, regardless of geography, religion, conflict or even the strength of the health system. This experience in scaling up to implement fully the eradication strategies is now one of the most valuable assets of the pro￾gramme. Perhaps the most frequent, if unfair, criticism of the highly regarded smallpox eradi￾cation effort was that it left little infrastructure behind to tackle other diseases. Indeed, the ultimate legacy of the polio eradication initiative will depend largely on the extent to which the experience and lessons learnt are used in scaling up the delivery of other health services. Surveys not started Surveys under way Surveys completed, inventories submitted Figure 4.3 Global action plan for laboratory containment of wild polioviruses, February 2003