International Vaccine Institute
The International Vaccine Institute (IVI) is an international nonprofit organization that was founded on the belief that the health of children in developing countries can be dramatically improved by the use of new and improved vaccines. Working in collaboration with the international scientific community, public health organizations, governments, and industry, IVI is involved in all areas of the vaccine spectrum – from new vaccine design in the laboratory to vaccine development and evaluation in the field to facilitating sustainable introduction of vaccines in countries where they are most needed.
Created initially as an initiative of the UN Development Programme (UNDP), IVI began formal operations as an independent international organization in 1997 in Seoul, Republic of Korea. Currently, IVI has 40 countries and the World Health Organization (WHO) as signatories to its Establishment Agreement. The Institute has a unique mandate to work exclusively on vaccine development and introduction specifically for people in developing countries, with a focus on neglected diseases affecting these regions.
Structure of the IVI
In accordance with the Article VIII of the Constitution of the International Vaccine Institute, the organs of the Institute are i) the Board of Trustees and ii) the Director and staff.[1]
Role of the Board of Trustees
As functions and powers of the Board, the Board is liable for all the affairs of the IVI. Thus, its role shall ensure that, in accordance with the Article X of the Constitution, i) the Institute follows objectives, programs and plans that are consistent with its aims and with the broad goals and objectives of the CVI, and ii) the Institute is managed effectively by the Director in harmony with the agreed objectives, programs and budgets, and with in accordance with legal and regulatory requirements.[2]
The composition of the Board of Trustees consists of not less than seventeen nor more than twenty-two members, as stated by the Article IX of the Constitution. However, in selecting the members of the Board, IVI has to follow following rules: 1) Up to ten members-at-large elected by the Board. Regard shall be paid especially to proposed members’ professional experience and qualifications, to appropriate geographical distribution, to agencies and countries which have concern for and provide substantial support to the Institute, or to countries where major facilities are located; 2) two members appointed by the host country; 3) two members appointed by WHO; 4) up to five members elected by the Board upon recommendation of governments of the Parties to this Agreement; 5) one member elected by the Board upon recommendation of UNDP; 6) the Executive Secretary of the GAVI, or his representative, as a member ex officio; and 7) the Director of the Institute as a member ex officio.[3]
Role of the Director
As the Article XIII of the Constitution of the IVI mentions, upon a two-thirds majority of members of the Board present and voting, the Director of the IVI is appointed by the Board, which determines the Director’s terms of office and termination.[4]
In 2015, Jerome Kim, M.D. was appointed as the new Director General of the IVI, and with the powers of the Director, Jerome Kim, M.D. is now the legal representative of the IVI. As the main duties of the Director General, the Director is responsible for the operation and management of the Institute and is also liable for ensuring that programs and objectives of the Institute are properly developed and carried out, in accordance with the Article XIV of the Constitution of the IVI.
Currently, under the Director General of the IVI, the IVI has mainly divided its works into 5 divisions: 1) Development and Communications Division (D&C), 2) Administration and Finance Division (A&F), 3) Laboratory Sciences Division (LSD), 4) Translational Research Division (TRD), and 5) Dengue Vaccine Initiative (DVI). Nevertheless, among these 5 divisions, Laboratory Sciences Division (LSD) and Translational Research Division (TRD) are the most important teams that conduct several experiments and vaccine programs of the IVI.
Signatory Countries of the IVI
As of January 2011, IVI includes 40 countries and the World Health Organization (WHO) as signatories to its Establishment Agreement. To be more specific, there are 33 signatory countries, which are the states that express their consent to be bound by a treaty by signing the treaty without the need for ratification, acceptance of approval. These states may definitively sign a treaty only when the treaty so permits. In addition, there are 16 parties which involve Liberia, Republic of Korea, Brazil, Mongolia, China, Sri Lanka, Ecuador, Sweden, Netherlands, Oman, Pakistan, Uzbekistan, Vietnam, Peru, Philippines, and the World Health Organization (WHO). A major difference between a signatory and a party is that a party to a treaty is a state or other entity with treaty-making capacity that has expressed its consent to be bound by that treaty by an act of ratification, acceptance, approval or accession etc. where that treaty has entered into force for that particular State.
In short, in addition to the World Health Organization (WHO), 40 countries include Bangladesh, Liberia**, Republic of Korea**, Bhutan, Malta, Romania, Brazil**, Mongolia**, Senegal, China**, Myanmar, Sri Lanka**, Ecuador**, Nepal, Sweden**, Egypt, Netherlands**, Tajikistan, Indonesia, Oman**, Thailand, Israel, Pakistan**, Turkey, Jamaica, Panama, Uzbekistan**, Kazakhstan, Papua New Guinea, Vietnam**, Kyrgyzstan, Peru**, Lebanon, Philippines**, Cote d'Ivoire, India, Kuwait, Slovakia, Spain, and United Arab Emirates.[5] .
(NOTE: ** represents parties to the agreement, and Liberia and Oman were approved through Accession and they have deposited the Instrument of Accession at the United Nations Treaty Office. )
(NOTE: states approved by the Board of Trustees and Instrument of Accession to be deposited with the UN Secretary-General are Cote d'Ivoire, India, Kuwait, Slovakia, Spain, and United Arab Emirates.)
(State approved by the Board of Trustees and Instrument of Accession means a state that has signed the Agreement and has been approved by the IVI Board of Trustees, only after the time the treaty is open for signature.)
The UN Millennium Development Goals and Contribution of the IVI
To combat infectious diseases through innovations in vaccine design, development, and introduction, addressing the needs of people in developing is the main mission of the IVI.[6] However, in addition to the major mission of the IVI, as the United Nations presented the new global agenda in September 2000, which is the Millennium Development Goals (MDGs), the IVI is also trying to achieve the UN Millennium Development Goals.
As a UN initiative, the UN Millennium Development Goals consists of eight international development goals, and these objectives are targeted to be achieved by the year of 2015. Here are the eight international development goals that need to be achieved: 1) Eradicate extreme hunger and poverty, 2) Achieve universal primary education, 3) Promote gender equality and empower women, 4) Reduce child mortality, 5) Improve maternal health, 6) Combat HIV/AIDS, malaria and other diseases, 7) Ensure environmental sustainability, 8) Develop a global partnership for development.[7]
Among the 8 Millennium Development Goals, the mission of the IVI supports 4 MDGs.
The IVI’s Support for Millennium Development Goal 1
First of all, the IVI tries to eradicate extreme poverty and hunger (Millennium Development Goal 1). With the prevention of unnecessary deaths via the use of vaccines, vulnerable people, but especially children, will enjoy healthy lives and therefore can contribute to the development of economy of their countries as productive workers. Thus, the IVI helps decreasing poverty and stimulating development of economies by leading people to have healthy lives.
The IVI’s Support for Millennium Development Goal 4 and 6
Secondly, the IVI reduces child mortality (Millennium Development Goal 4) and, thirdly, the IVI combats HIV/AIDS, malaria and other diseases (Millennium Development Goal 6). Acute respiratory infection (ARI) is a major factor that contributes to illness and death of children under the age of five.[8] In 2000, the WHO estimated that 1.9 million children all over the world die each year from ARI and 70% of the deaths are in Africa and Asia [9] Therefore, in order to reduce child mortality and to prevent other diseases, the IVI highly puts its emphasis on its important role of the Division of Translational Research and the Division of Laboratory Sciences for addressing new-generation vaccines against infectious diseases, but especially diarrhea, ARI, Japanese encephalitis, and dengue fever.
The Division of Translational Research promotes discoveries in vaccine research into practical public health tools and introduces vaccines to developing countries in order to lessen the disease burden and to improve the access of vaccines for children. In addition, the Division of Laboratory Sciences designs vaccines, sets new vaccine targets, builds new routes of administration in order to transfer vaccine manufacturing processes and technologies to developing countries. Therefore, currently, the IVI’s main strategies to decrease child mortality rates and to prevent infectious diseases are implemented with Cholera Vaccine Program, Typhoid Vaccine Program, Dengue Vaccine Initiative, SIVAC Initiative, Meningitis in Niger Program, Japanese Encephalitis Vaccine Program, Respiratory Pathogen Vaccine Program, Rotavirus Diarrhea Vaccine Program, and DPRK Program.[10]
The IVI’s Support for Millennium Development Goal 8
Fourthly, the IVI develops a global partnership for development (Millennium Development Goal 8). As the WHO officially announced by issuing the WHO Position Paper on Cholera Vaccines in 2010, there are only two available cholera vaccines on the world market: Dukoral and Shanchol.[11] However, unlike Dukoral, which is made by a Dutch corporation, Crucell, Shanchol is the first licensed oral cholera vaccine in 2009 that is developed by an international organization, the International Vaccine Institute (IVI), with supports from the Government of Republic of Korea, the Swedish International Development Cooperation Agency (SIDA), and Bill & Melinda Gates Foundation. Furthermore, what is significant about Shanchol is that it does not require administration with buffer, meaning that its use is simplified, and therefore this oral cholera vaccine can be greatly used in refugee camps and other post-crisis situations. In addition, government and international agencies are able to purchase Shanchol at a very low cost (e.g. approximately $1). Thus, in India in 2009, in order to boost global partnership and the global use of the new oral cholera vaccines, Shanchol, with a simplified use and a low cost, the IVI transferred its technology for the vaccine to Shantha Bioethics of Hyderabad, which is an India pharmaceutical company that is a major vaccine supplier to UNICEF.[12]
Achievements
- IVI has developed 3 new or improved vaccines: reformulated oral cholera vaccine, typhoid Vi polysaccharide vaccine, and typhoid Vi conjugate vaccine.
- Shanchol™, the oral cholera vaccine developed and licensed under guidance by IVI, was prequalified by WHO in September 2011.
- IVI has completed a global investment case for cholera vaccines, the first report to systematically provide detailed estimates of the disease burden of cholera and the global cost-effectiveness of cholera vaccination.[13]
- IVI and the National Institute of Cholera and Enteric Diseases (NICED) jointly established a state-of-the-art immune-monitoring laboratory in Kolkata, India.
- IVI was the first to identify that Japanese encephalitis is a major problem in Bali, Indonesia.
- IVI scientists developed the first animal model of Shigella colitis for use in developing a Shigella vaccine.
- Since 2000, IVI has hosted an annual International Advanced Course on Vaccinology for the Asia-Pacific Region to build country capacity in vaccine-related research.
- IVI demonstrated for the first time that killed oral cholera vaccine is effective in populations with high rates of HIV/AIDS(Mozambique).[14]
References
- ^ Article VIII of the Constitution of the IVI. 'Organs of the IVI.'
- ^ Article X of the Constitution of the IVI. 'Functions and Powers of the Board.' [1]
- ^ Article IX of the Constitution of the IVI. 'Composition of the Board.'
- ^ Article XIII of the Constitution of the IVI. 'Appointment of the Director.' [2]
- ^ Governance. 'Signatory Countries.'
- ^ Institutional Vision and Mission. 'Strategic Plan 2008-2012: Combating Infectious Diseases of the Developing World through Innovation in Vaccines and Vaccination.' March 2008, accessible at http://www.ivi.int/publication/strategic_plan/IVI_StrategicPlan_2008.pdf
- ^ UN Millennium Project. 'Millennium Development Goals'
- ^ Division of Translational Research. 'Respiratory Pathogen Vaccine Program.' [3]
- ^ Initiative for Vaccine Research. 'Acute Respiratory Infections.'
- ^ IVI. 'IVI Programs.'
- ^ WHO. 'Updated WHO Position Paper on Cholera Vaccines." March 2010, accessible at http://www.who.int/immunization/cholera_PP_slides_20_Mar_2010.pdf
- ^ IVI. "Oral Cholera Vaccine: First Licensed Vaccine Developed with Gates Foundation Support." [4]
- ^ IVI publication. 'An Investment Case for the Accelerated Introduction of Oral Cholera Vaccines.' March 2012, accessible at http://www.ivi.int/publication/IVI_Global_cholera_case.pdf.
- ^ Globe Network. 'Fondation Mérieux Report of the Meeting on Focus on Neglected Tropical Infectious Diseases: Integrating Vaccines into Global Cholera Control Efforts.' April 2009, accessible at http://www.globe-network.org/documents/conferences/2009/Focus-on-neglected-tropical-infectious-diseases-Integrating-vaccines-into-global-cholera-control-efforts/Scientific-report.pdf