An independent monitoring board convened by the worldwide polio-eradication initiative has delivered a report on the global effort that is striking for its brutally frank and even frustrated tone.

Among its findings, just in its first few pages: “Case numbers are rising”; “unwelcome surprises continue”; “as many milestones are being missed as are being met”; and “the (eradication) Programme is not on track for its end-2012 goal, or for any time soon after unless fundamental problems are tackled.”

Possibly the biggest problem, the board concludes, is a get-it-done optimism so ingrained in the...