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Dr. R. Palmer Beasley (1936-) is an internationally well-known physician, public health educator and epidemiologist whose work has involved extensive investigations in Taiwan and has established that hepatitis B virus (HBV) is a primary cause of liver cancer and that hepatitis B is transmitted from mother to infant during childbirth. Dr. Beasley and his colleagues also proved that HBV mother-to-infant transmission is preventable by at-birth vaccination. Due to his breakthrough work, the World Health Assembly designated HBV as the seventh global vaccine in 1992. He later became the author of HBV immunization policies of the World Health Organization. Dr. Beasley is also a world expert on public health education. He served as the Dean of the University of Texas Health Science Center at Houston (UTHealth) School of Public Health (UTSPH) in unusual term from 1987 to 2004. During this period, he established the Center for Infectious Diseases, now headed by Dr. Herbert L. Dupont, a world renowned expert in infectious disease. Dr. Beasley and Dr. Dupont have been responsible for a number of efforts to establish international programs, mostly notable in Zambia and India. During his deanship, he assisted foreign schools of public health (i.e., Xi'an Jiaotong University) to establish their MPH programs. In 2003, he traveled to China and Taiwan to help investigating the SARS epidemic.

During his career, Dr. Beasley received a number of prestigious international awards and/or prizes, including the King Faisal International Prize in Medicine in 1985, the Charles S. Mott Prize in Medicine in 1987 , the Prince Mahidol Award in Medicine in 1999 , the Taiwan National Health Prize 1st Order in 2000 , the Hepatitis B Foundation’s Distinguished Scientist Award in 2010  , and recently the 2011 Maxwell Finland Award from the National Foundation for Infectious Diseases.

EARLY LIFE AND EDUCATION
Dr. R. Palmer Beasley was born in Glendale, California in 1936 to Robert Seth Beasley and Bernice Palmer Beasley. Both his grandfather and father were bankers and his mother was a lecturer. Both Palmer Beasley and his young brother, Bruce Miller Beasley, attended public schools.

Palmer Beasley received his Bachelor of Arts (BA) degree in philosophy, with a concentration in causation from Dartmouth College in 1958. He studied medicine at Harvard Medical School where he was a student of Maxwell Finland and graduated in 1962. Upon graduating from medical school, he interned at King County Hospital in Seattle, WA. From 1963 to 1965 he worked in the Epidemic Intelligence Service (EIS) in Atlanta, GA. Dr. Beasley returned to Seattle in 1965 to start his residency at the University of Washington Hospital and became a senior fellow in preventive medicine at the University of Washington School of Medicine in 1967.

ACADEMIC CAREER
From 1969 to 1986, Dr. Beasley was an Assistant Professor, then Associate Professor, then full Professor of Preventive Medicine (adjunct with Internal Medicine) in the Department of Epidemiology, the University of Washington School of Public Health and Community Medicine. Also in 1979, he became Director of American University Medical Center (AUMC) in Taipei, Taiwan. From 1986 to 1987, Dr. Beasley served as Professor of Medicine and Head of the Division AIDS and Chronic Viral Infections at the University of California, San Francisco(UCSF). He assumed the position of Dean at the University of Texas Health Science Center at Houston (UTHealth) School of Public Health (UTSPH) from 1987 till 2004. In 2005, he stepped down from the Deanship and is currently an Ashbel Smith Professor, Director of the Center for International Training and Research (CITAR) and Dean Emeritus, the University of Texas Health Science Center at Houston (UTHealth) School of Public Health. Currently, CITAR attracts international students from Asia, mostly from Vietnam, and Africa to attend courses, seminars and research in HIV/AIDS and cancers caused by infectious agents.

RESEARCH ON HEPATITIS B
Before working Hepatitis B, Dr. Beasley worked on rubella in Taiwan during late 1960s and early 1970s with Professor Thomas Grayston who was the first Dean and founder of the University of Washington School of Public Health and later became the Vice President of the University of Washington (UW). While working on a project of efficacy of Rubella vaccine, Dr. Beasley became interested in hepatitis as "the infectious disease problem least understood and seemingly most important among those that remained unconquered after polio, smallpox, and measles had been brought under control." .

In 1964, Dr. Baruch Samuel Blumberg discovered a surface antigen for hepatitis B in the blood of an Australian aborigine and, together with his team, developed a screening test. Dr. Baruch Samuel Blumberg was awarded later 1974 Nobel Prize for his discovery. The Abbott Laboratories then developed a more sensitive and specific radioimmunoassay technique to detect surface antigen of Hepatitis B. Dr. Beasley was excited that this technique would bring a new tool for his epidemiological study on Hepatitis B.

At that time, Hepatitis B was known to be transmitted only from blood (i.e., transfusions, injections, blood products or inadvertent needle sticks). It, however, an important question occurred to him: “How was the virus transferred prior to the advent of modern technology?”

"Since transfusions are relatively recent in human history, how was this agent transmitted in nature before that?" he asked. Beasley says he "got a lot of puzzled looks" but no answers. "I suggested we ought to look to see if it isn't transmitted from mothers to babies, since that's the commonest way in nature that blood is shared between people. With that hypothesis I went to Taiwan and, with the [[Abbott Laboratories]] test, began screening and detecting carrier pregnant women in the obstetric clinics at the hospitals in Taipei. After some months of doing this, we had determined that almost 20% of the mothers in Taiwan were hepatitis B carriers, which is a phenomenally high rate." That figure contrasts sharply to a rate of less than 1% in the U.S. "About 40% of the babies of those carrier-mothers became infected," said Beasley.

He then showed that “E” antigen is a good predictor for the vertical transmission mother-to-infant. This observation lead to new clinical trials on the hypothesis whether the Hepatitis B immune globulin (HBIG) protect newborns from being vertically transmitted from their mothers. Dr. Beasley and his team reported that babies receiving HBIG within a few hours of birth were protected whereas there was no protection on those who received HBIG after 24 hours. HBIG was then refined to give all newborns within minutes after births. The results were astounding as the incidence of infection was reduced by approximately 75%.

At the same time, Dr. Beasley tried to test his hypothesis that hepatitis B causes liver cancer. However, he “ran into enormous skepticism by almost everybody” and “people were saying I was crazy”. The notion at that time was that the cause of liver cancer was already known: aflatoxins and that with the start of the War on Cancer, beginning in 1975, major focus was on environmental factors.

He, however, proceeded and designed one of the first large cohort studies to test his hypothesis. With his co-investigator Dr. Lu-Yu Hwang and the Taiwan team of investigators, they conducted a study of over 22,000 government workers from 1974 and followed them up to now. They reported that the risk of liver cancer was 60 times higher in chronic HBV infected persons than non-HBV carriers and the life time risk of dying from liver cancer was 40% in men and 15% in women. Noted that the association between liver cancer and HBV carriers was stronger than the association between lung cancer and smoking (20-25 times). “It’s one of the highest relative risks that anyone has ever seen,” said Beasley. However, skepticisms remained “because many people feel that establishing causation requires elucidating a plausible mechanisms by which the effect occurs,” he recalled.

In 1984, a vaccine program was launched in Taiwan and, in 1997, Taiwan reported a significant drop in liver cancer rates in children under 15 years of age after the adoption of a national universal newborn vaccination program. After the recommendation of the World Health Organization in 1992, HBV vaccine has been used globally and was the only immunization to prevent a major human cancer at that time.

Thus, his work, together with the subsequent investigations by other researchers later proved that there is a causal relationship between hepatitis and liver cancer. In 2005, HBV officially recognized as one of 58 known agents that cause human cancer.

"Dr. Beasley has saved countless lives from cirrhosis and liver cancer through his work on the epidemiology and prevention of hepatitis B," according to Dr. Herbert L. du Pont, Director of the Center for Infectious Diseases at the University of Texas School of Public Health. "He is a giant in the field of infectious diseases." .

Dr. Samuel Katz (pediatrician), Chairman Emeritus of the Department of Pediatrics at the Duke Children’s Hospital and Health Center, has said, “Palmer’s abundant achievements are highlighted most by his 14 years in Taiwan, where he was responsible for a succession of investigations—clinical, epidemiological and laboratory—which led to a full understanding of the spectrum of hepatitis B virus infection. These studies elucidated its virology, immunology, transmission and clinical manifestations, including its causal link to chronic hepatitis, cirrhosis and hepatocellular carcinoma.” Dr. Beasley “demonstrated the efficacy of hepatitis B immune globulin in blocking infection, especially maternal-infant, and hepatitis B vaccine in its prevention. His longitudinal observations were first to demonstrate that hepatocellular carcinoma was prevented in Taiwanese males by early life vaccination. Subsequent studies involved the then newly identified hepatitis C virus,” Dr. Katz writes.

According to Dr. Cladd E. Stevens, his former student at UW and who worked with Dr. Beasley in Taiwanese studies, “Dr. Beasley’s work has lead to the thorough understanding and effective prevention of HBV infection and its long-term consequences on a global scale, making hepatocellular carcinoma and cirrhosis of the liver – one of the primary causes of death for much of the developing world of Asia, Africa and the Middle East – a thing of the past for current and future generations.”.

When Dr. Beasley received the Hepatitis B Foundation’s Distinguished Scientist Award in 2010, Roberta T. Ness, Dean of the University of Texas School of Public Health, said in The Medical News, “Dr. Beasley’s contributions to understanding the link between hepatitis B and liver cancer have saved thousands of lives. His work not only transformed our understanding of the cause of liver cancer, but then spearheaded the solution through vaccination.”.

PUBLIC HEALTH EDUCATION
Dr. Beasley represented UTSPH to the Association of Schools of Public Health (ASPH) for almost 20 years and during those years visited most of the now 38 schools of public health in the US, represented ASPH as a counselor/board member on the Council on Education for Public Health (CEPH), chaired several of the key committees of ASPH - the Education Committee, the International Health Committee and the Executive Committee as Treasurer, Vice President and later President of ASPH. As President of the ASPH he led efforts to strengthen the accreditation criteria and procedures used by CEPH, increase practical as part of MPH level education, establish credentialing for public health professionals, increase funding for National Institutes of Health (NIH) and CDC, reform CDC to included better funding for extramural investigators, build closer ties with foreign schools of public health. He has visited many schools of public health in many countries and as President of ASPH he initiated an effort to have the schools cooperated in an effort to encourage public health education in India through the establishment of national schools of public health. He has also served as internal advisor to several established foreign schools of public health, e.g. London School of Hygiene & Tropical Medicine, National Taiwan University School of Public Health and schools in evolution e.g. Kyoto University. In his roles on CEPH and ASPH he has reviewed the accreditation documents of every school of public health in the United States.

In 2005 the SPH gave greater emphasis to international health when it created a new cross-divisional Global Health Program with funding from an FIC Framework grant jointly to UT and Baylor College of Medicine. This highly successful program has stimulated increasing numbers of students and faculty to learn about global health issues and seek experiences in developing countries.

After stepping down from the Deanship in 2005, Dr. Beasley has devoted most of his time and effort to global health research and training. In 2004, he created CITAR to provide a training focus for foreign students seeking graduate level proficiency related to HIV research with its initial focus on Vietnam. In 2007, he began a program of summer research internships for American students in international settings.

PERSONAL LIFE
Dr. Beasley is married to Dr. Lu-Yu Hwang, who is also a world-renown expert in HIV and HBV and is currently a Professor of Epidemiology at UTSPH. They have three children: Fletcher, Monica and Bernice.

Fletcher, who lives in Los Angeles, is a composer. He is married to a painter and they have one daughter. Monica is married to an attorney. They live in Seattle and also have one daughter. Bernice, a graduate from the State University of North Carolina, and lives in Seattle, WA.

BOOKS
Dr. Beasley was the Chair of the Committee on the Prevention and Control of Viral Hepatitis Infections Board on Population Health and Public Health Practice at Institute of Medicine of the National Academy of Sciences for the book titled “Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C”, edited by Heather M. Colvin and Abigail E. Mitchell and published in 2009.

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