People from Nigeria, Pakistan and Afghanistan should not be allowed to leave their country unless they can show they have been vaccinated against polio, according to the body which monitors attempts to eradicate the disease.
A report from the Independent Monitoring Board (IMB) of the Global Polio Eradication Initiative says every time a child or adult from these three countries travels abroad, they risk carrying the polio virus with them.
Nigeria, Pakistan and Afghanistan are the only countries where polio remains endemic, which means transmission of the virus has never been stopped.
There has also been a handful of polio cases in Chad this year.
The report says all but 0.1% of polio has been eradicated globally: there have been 175 cases so far in 2012 compared to 350,000 in 1988.
The IMB says its target of stopping global polio transmission by the end of the year will clearly not be achieved.
And its report says there is a 'significant risk' of having more polio cases in 2013 than in 2012.
But the Board, which is chaired by Sir Liam Donaldson the former Chief Medical Officer for England, says there are reasons to be optimistic.
It cites India's achievement in January 2012 of being free of polio for a year as a major landmark, which meant it was removed from the list of endemic countries.
Nigeria is the only country which has seen an increase in the number of cases this year.
The report concludes there is a 'magic formula' that is still missing in the affected countries, which it calls 'absolute ownership': this means parents demanding the vaccine for their children and local leaders grasping the challenge of wiping polio from their area.
It says: "Most of all ownership is about national pride: a country determined to be a vibrant 21st century nation, not one that is looked down on because it remains tainted by a disease that almost everywhere else in the world survives only in the memory of grandparents."
Vaccine-derived polio virus
The live oral polio vaccine can, in extremely rare cases, cause the paralysing disease it is seeking to prevent and allow the virus to spread in the community.
The IMB says there have been 34 cases of circulating vaccine-derived polio virus this year in Nigeria, Democratic Republic of Congo, Kenya, Somalia and Pakistan.
The injectable vaccine used in Britain and other developed countries contains an inactivated, or killed poliovirus.