Authors:
Javier Casellas, M.D., Ph.D.
Enrique Chacon-Cruz, M.D., MSc
Felicitas Colombo, MPA
Jerome H. Kim, M.D., serves as the Director General of the International Vaccine Institute (IVI) and is an international expert in vaccine development and evaluation.
Before joining IVI, Dr. Kim held several prominent positions, including Principal Deputy of the U.S. Military HIV Research Program and Chief of the Laboratory of Molecular Virology and Pathogenesis at the Walter Reed Army Institute of Research. He was also the U.S. Army Program Manager for HIV vaccines and led the Army’s RV144 Phase III HIV vaccine trial, which demonstrated efficacy in preventing HIV-1.
Dr. Kim is an Adjunct Professor in the Department of Medicine at the Uniformed Services University of the Health Sciences in Bethesda, USA, and at the Graduate School of Public Health at Yonsei University in the Republic of Korea. He is also an Honorary Professor at the University of Rwanda and was named a Distinguished Visiting Professor at Seoul National University in 2022. He has authored over 350 publications.
A graduate of the University of Hawaii, Dr. Kim earned high honors in History and the highest honors in Biology. He received his M.D. from Yale University School of Medicine and completed his training in Internal Medicine and Infectious Diseases at Duke University Medical Center.
As part of his achievements, Dr. Kim has received numerous awards, including the John Maher Award for Research Excellence from the Uniformed Services University (2013), the Department of the Army Research and Development Achievement Award for Technical Excellence (2013), the Asia Pacific Vaccine Excellence Lifetime Achievement Award (2021), and the Medal of Honor for Civil Merit from the Government of the Republic of Korea (2022).
https://www.ivi.int/who-we-are/leadership/jerome-h-kim/
The International Vaccine Institute (IVI)
Founded in 1997 as an initiative of the United Nations Development Program (UNDP), IVI’s mission is to discover, develop, and deliver safe, effective, and affordable vaccines for global health.
Dr. Jerome Kim emphasizes the importance of this mission: “As a natural consequence of developing vaccines for countries and diseases that aren’t common in the Global North, IVI is deeply committed to enabling countries and partners to establish vaccine security.”
Before leading IVI in 2015, Dr. Kim was involved in technology transfer to enable the manufacturing of an HIV vaccine in Thailand. He reflects on IVI’s accomplishments: “With a similar challenge to HIV, but now addressing other neglected disease vaccines, IVI has done remarkably well in its 27-year history.”
For some countries, this means simply gaining access to vaccines, while in others—especially in the post-COVID-19 pandemic landscape—it’s about ensuring vaccine security through local manufacturing and bolstering epidemiology, surveillance, discovery, development, and delivery.
“Although we work across the entire vaccine value chain—from epidemiology, to discovery, to delivery, to postmarketing surveillance and health economics—we do not manufacture vaccines ourselves. That’s part of our establishment agreement,” Dr. Kim asserts.
IVI’s mission is critically relevant today, particularly in filling vaccine research and development gaps for neglected diseases that primarily affect low- and middle-income countries where major pharmaceutical companies often do not invest. Ironically, many neglected diseases are now emerging in high-income countries as well, necessitating a paradigm shift in global health.
Pharmaceutical companies are often driven by stockholder interests, and their revenues come from diseases affecting high-income countries,” he emphasizes. “This situation places IVI in a unique position, as we understand the critical need to fill the gap and profound impact vaccines have on health, economic growth, pediatric development, cognitive development, and education.”
IVI’s portfolio
IVI’s portfolio features an extensive array of vaccines in development. Collaborating with the World Health Organization (WHO), Gavi, National Immunization Technical Advisory Groups, and other organizations, IVI aims to create a compelling global health investment case, ensuring that vaccination can proceed smoothly once a safe and effective vaccine is available.
For example, technology transfers to several companies have resulted in the world’s only stockpile of oral cholera vaccine, which previously held 70 million doses. However, demand for this vaccine has significantly outpaced manufacturing capacity, leaving the stockpile completely empty.
“We recently received funding to enter phase three testing for this technology-transferred oral cholera vaccine, which will be the first successful drug substance tech transfer to Africa since the 1930s. This is a testament not only to the capabilities of African manufacturers but also to our commitment to advancing vaccine technology to countries capable of achieving such technological feats,” Dr. Kim proudly states. He also notes that IVI has developed a WHO pre-qualified typhoid conjugate vaccine.
Before any impact on public health can be realized, IVI provides cost-effectiveness data to ministries of health and finance, which will ultimately support the implementation of vaccination programs.
“In global health, when developing a cholera or typhoid vaccine, we must not only demonstrate that the vaccine is safe and effective but also provide the necessary economic and health justification for its use. We are well accustomed to this challenge,” claims Dr. Kim.
IVI in Africa
Headquartered in Seoul, South Korea, IVI is increasingly focusing its efforts in Africa, supported significantly by the Bill & Melinda Gates Foundation’s commitment to vaccine development in the region and other funders including CEPI. Rwanda hosts the IVI Africa Regional Office, serving as the primary footprint for partner engagements. IVI’s “Advancing Vaccine End-to-End Capabilities (AVEC)” program based in Kenya works toward sustainable vaccine manufacturing on the continent. IVI reaches more than 20 countries across Africa, aiming to secure grants that enhance the ecosystem by facilitating the transfer of capabilities to governments, academia, and manufacturers.
Currently, less than 1% of the vaccines used in Africa are manufactured locally, prompting countries to commit USD 5 billion to boost vaccine manufacturing. IVI is working to strengthen this relatively weak ecosystem to enable capabilities across the entire value chain. For context, South Korea improved its self-sufficiency in vaccine manufacturing from 20% in 2010 to about 50% in 2025, with a target of reaching 80% by 2030.
IVI takes vaccines from the laboratory to the clinic, collaborating with manufacturers to facilitate production and navigate regulatory approval for WHO pre-qualification. The organization also partners with regional authorities and WHO to make recommendations for vaccine use and works with Gavi to establish mechanisms for purchasing the vaccines. Through initiatives like Advancing Vaccine End-to-End Capabilities (AVEC), IVI serves as the project management agency to ensure successful execution.
“Africa has now developed solutions on its own. Gavi is committed to the African Vaccine Manufacturing Accelerator (AVMA), which enables them to purchase African-manufactured vaccines at a slightly higher cost. However, the broader ecosystem is still not fully established,” Dr. Kim notes, emphasizing the importance of public-private partnerships.
Vaccines as a commodity
While vaccines are highly specialized and unique, Dr. Kim notes that they are often treated as commodities in the global trade arena. Vaccines have become standardized, fungible goods purchased in large quantities from the lowest bidder in the market.
This has led to significant efficiency and consolidation in vaccine manufacturing in the Global North, where market forces largely dictate pricing. However, this model falls short when it comes to equitable allocation of vaccines. Dr. Kim argues that national security interests often overshadow market dynamics.
So how do these models fit into the broader landscape of global health? Some countries are advocating for private ownership, while others rely on state and international funding to advance vaccine production. Many nations recognize the necessity of paying a bit more for local manufacturing security, understanding that without their purchases, companies may cease to exist. With the development of local manufacturing capacity comes the expectation of higher vaccine costs.
However, the high efficiency and quality of vaccines produced by major pharmaceutical companies make it challenging for smaller manufacturers to compete, especially as new vaccines are introduced.
“Actually, the largest burden of unvaccinated children is in middle-income countries, which do not benefit from Gavi’s revolving fund and its dollar-a-dose vaccines. These countries often lack the birth cohorts large enough to negotiate effectively with manufacturers and do not have local industries capable of fill-and-finish operations,” Dr. Kim points out.
Currently, a model exists for countries willing to pay a bit more for vaccine security through regional agreements that allow for equitable distribution during pandemics, negotiated in advance of outbreaks.
“It’s a complicated issue and somewhat counterintuitive. It highlights the failures of markets and the difficulties countries face in purchasing vaccines,” he concludes. This situation challenges the conventional notion of free markets and their efficiency.
The future at IVI
IVI engages across the comprehensive vaccine research and development lifecycle that encompasses education, manufacturing, clinical development across all phases, regulation—including collaboration with WHO—and implementation. In addition to traditional vaccine development, IVI is currently exploring innovative methods of vaccine delivery to complement conventional needle, syringe and oral routes.
“We have begun funding initial work on the development of patches for vaccine delivery, which we refer to as microarray patches or Multiple Antigen Presenting systems (MAPs). This remarkable technology includes a specific patch that will enter human clinical trials next month. You apply it, and within five minutes, it delivers more than 80% of the drug into the dermis,” Dr. Kim explains.
When this technology becomes available, it could revolutionize the administration of essential vaccines, allowing for delivery without the need for a specialist. Moreover, newer versions of the patch, provided they can freeze-dry or lyophilize the product, have the potential to hold multiple vaccines.
“Currently, there is work underway on a pentavalent version of the patch. We know that we can incorporate mRNA into a patch, and preliminary results in animals show that it produces levels comparable to those achieved through injection. This could be the next significant advancement,” he shares enthusiastically.
“I believe that the model of innovation to advance global health goals is crucial and will make a substantial difference in the long term. At a small international organization like IVI, we are committed to creating benefits not only for the global community but also for the countries that support us,” Dr. Kim concludes.
