As the GPEI program evolved, changes to AFP surveillance policies (eg, universal adoption of virological confirmation and discontinuing use of the poliomyelitis clinical case definition) and performance targets (AFP case detection rate shifted from 1 to 2 per 100000 in persons <15 years of age in polio-endemic regions) [4, 5] caused significant increases in laboratory workloads (Figure 3). This evidence concerns the gene AFP and poliomyelitis.