The Diseases of the Most Impoverished (DOMI) Program was launched at the start of 2000 after receipt of generous funding from the Bill and Melinda Gates Foundation.

The DOMI Program is an eight-year effort funded with a grant of $40 million by the Bill and Melinda Gates Foundation. DOMI addresses the need for research and development of vaccines against three important enteric diseases - cholera, shigellosis, and typhoid fever - that collectively account for hundreds of thousands of deaths each year, largely among children.

The development and deployment of a vaccine requires the execution of a complex multi-disciplinary set of activities. To this end, IVI has brought together internationally recognized experts in laboratory research, vaccine production and regulation, vaccine clinical and field evaluation, policy and economic analysis, market research, and socio-behavioral research. It has successfully led the design and implementation of a coordinated program in the eight DOMI target countries: Bangladesh, China, India, Indonesia, Mozambique, Pakistan, Thailand, and Vietnam. The DOMI Program is now recognized as a focal program for the global agenda to accelerate the development and introduction in developing countries of vaccines against cholera, shigellosis, and typhoid fever. A unique aspect of the DOMI Program is the in-house IVI technical expertise, which ensures both effective program direction as well as continuous interaction in research activities to promote coordination and scientific excellence.

The main objectives of DOMI are to:

• Generate and disseminate evidence needed by policymakers for rationally introducing existing, licensed, new-generation vaccines against cholera and typhoid fever;
• Help assure an adequate and cost-competitive vaccine supply of killed, whole-cell oral cholera and Vi polysaccharide typhoid vaccines by transferring production technologies to qualified producers in Asia and providing training in vaccine production and regulation;
• Ensure the pipeline of newer-generation experimental vaccines against cholera, typhoid fever, and shigellosis is exploited by evaluating these vaccine candidates in endemic settings and by generating evidence of the need for these vaccines; and
• Help develop a consensus at national, regional, and international levels on the use of vaccines against these three diseases.

In addition to funding from the Gates Foundation, the DOMI program has also received support from the Republic of Korea, the Swedish International Development Cooperation Agency, the Government of Kuwait, AusAID, the Japan International Cooperation Agency, the Rockefeller Foundation, the UBS Optimus Foundation, the Wellcome Trust, the National Institute for Biological Standards and Controls (U.K.), Medecins Sans Frontieres, the University of Gothenburg, GlaxoSmithKline Biologicals, Sartorius AG, Emergent Product Development (formerly Microscience), AVANT Immunotherapeutics, and Swedish Bacteriological Laboratories.