The International Vaccine Institute, an international organization founded 20 years ago in Korea as an initiative of the United Nations Development Program, was a bold vision – a vision that, in 1997, showed remarkable leadership and foresight for a country that had itself risen from the devastation of war to new economic strength. The idea that Korea and its partners pledged to create and sustain was an organization dedicated to the development of low cost, high quality vaccines for low income countries.
This was an idea that, at its heart, held that people everywhere should lead healthy and productive lives, but how could a small international organization do what only governments and large vaccine companies had done in the past -- design, test, license and deliver new vaccines?
Furthermore, this international organization was going to work in the prevention of infectious diseases of developing countries, turning the model that vaccines are developed for diseases of high-income countries and then extended to the same disease in low-income countries -- for example, hepatitis B vaccine -- on its head.
The vaccines developed by this new organization would target diseases that did not exist in the United States, or in Europe, or in Korea. What business model would apply? Who would fund it, and who would buy vaccines whose target populations earned a dollar a day?
But this was the dawn of the new age of global health -- Korea initiated funding, the Bill and Melinda Gates Foundation, and Sweden joined, and the first big programs at IVI -- the Diseases of the Most Impoverished and the Pediatric Dengue Vaccine Initiative were initiated. Work was started on a vaccine against the deadly diarrheal disease cholera, which kills 95,000 people per year and is particularly a problem in displaced populations -- refugees, victims of floods, earthquakes, hurricanes. The vaccine -- a collaboration between IVI, Vietnam and Sweden -- was transferred to Shantha Biotechnics (now part of Sanofi) in India and by 2011 the world had a low cost, effective oral cholera vaccine for the first time.
Gavi, the Vaccine Alliance created the World Health Organization’s OCV stockpile for use in emergencies, but demand for that vaccine outstripped supply. IVI initiated transfer of OCV to EuBiologics, a Korean company, that quickly developed and tested the OCV, which is now approved by the WHO. In a short period of time, Korea, through EuBiologics, became the world‘s largest supplier of OCV.
More than 26 million doses have been supplied or deployed in over 18 countries worldwide. In October the vaccines prompted the WHO to launch "Ending Cholera -- A Global Roadmap to 2030," an ambitious strategy aimed at reducing cholera deaths by 90 percent by 2030. The WHO calls the introduction of the oral cholera vaccine a “game-changer in the battle to control cholera, bridging the gap between emergency response and longer-term control.”
The work is not done, and the memory of MERS, Ebola and Zika reminds us that in this global economy no nation can be isolated. Haiti, South Sudan, Yemen and the Rohingya refugees remind us that having a vaccine is not enough -- vaccines don’t save lives, vaccination does.
IVI and stakeholders are developing a new typhoid vaccine that will perform better in children with SK Chemicals of Korea and PT BioFarma of Indonesia. IVI has built a reputation around vaccines for neglected tropical diseases through partnership with efficient vaccine manufactures and support from the Gates Foundation.
Product development partnerships like IVI do not benefit from the vaccines they create and need support -- the support of countries like India, Sweden and Korea, the support of funders like the Bill and Melinda Gates Foundation and the Wellcome Trust, the support of donors like the Korea Support Committee, businesses, civic groups like Rotary International and individuals who have donated their time, talent and money to help IVI complete its mission. It is time for other G-7 and G-20 countries that believe in the value of vaccines to commit to the development of vaccines for endemic poverty-associated infections.
IVI begins its 3-D decade in a good place -- in funding, research and partnerships. But as the world’s only international organization devoted exclusively to vaccines for global public health, the institute needs to continuously improve and grow, respond more quickly to new global health and vaccine market environments, and develop expertise to move new vaccine priorities forward.
Korea’s vision, extraordinary leadership and commitment to global health, which has continued since IVI’s founding, deserve better recognition by the international community. As IVI moves to the next phase of development, we look forward to our continued partnerships with Korea, Sweden and India, and other nations and partners around the world to generate bigger impact in global public health.
By Jerome KimJerome Kim, MD, is Director General of the International Vaccine Institute. -- Ed.
