Newly-elected Academia Sinica Academician Mei-Hwei Chang set off on a remarkable career as a clinical pediatrician and researcher specializing in liver diseases following her graduation from the NTU Department of Medicine four decades ago. Chang is now a distinguished chair professor of the College of Medicine's Department of Pediatrics as well as director of the Hepatitis Research Center at NTU Hospital. The dedication and passion Prof. Chang has demonstrated in the fight to prevent childhood liver cancer and hepatitis B have helped to ensure the wellbeing of countless people. Her efforts have also made Taiwan a global leader in hepatitis research.
By providing evidence that hepatitis B vaccinations for newborns can effectively reduce the incidenceof liver cancer in children and teenagers by 70%, Prof. Chang and her research team proved for the first time that vaccinations can prevent cancer.This undoubtedly captured the attention of the international medical community.
Early in the spring of 1984, Prof. Chang compiled a massive epidemiological database focused on hepatitis B in children and teenagers. The data revealed that in Taipei City, 5% of infants aged one year old and under, as well as approximately 15% of children two years old and over, tested positive as carriers of the hepatitis B virus. Chang's investigation proved to be especially valuable, as its data was collected just prior to the initiation of a nationwide hepatitis B vaccination program for newborns in the summer of 1984, which allowed Chang to compare data from before and after the program's launch.
Prof. Chang says that in the early days of her work, virtually all of the liver cancer patients she encountered were people with hepatitis B, and that the children suffering from liver cancer were mostly six years old and older, with a small number as young as four. Since it was not common practice to test children for cancer in those days, most of Chang's young patients had already entered the advanced stages of the disease. She felt confounded by this situation and hoped to find a way to address the suffering of her patients. Chang explains, "During my investigation, my professors told me it would require 40 to 60 years to see a change. I was still young at the time and I felt there were too few scientists pursuing this type of research. Internationally, most of the research targeted adults while none concerned children. I witnessed the needs and problems of my patients, yet was able to find only a small amount of related research literature."
In 1983, working with limited personnel and resources, Prof. Chang managed to test over 1,000 children at elementary schools and daycare centers for liver cancer. The data she collected proved crucial to making Taiwan a leader in the international liver research community.
Now 30 years later, Prof. Chang still remains actively engaged in research. She is currently investigating with her team a mechanism she suspects plays a role in causing liver cancer to occur so early as childhood. With statistics showing that 81% of children with liver cancer have cirrhosis and 94% are born to mothers who carry hepatitis, Chang's team believes thatchildhood liver cancer is the accelerated version ofadult liver cancer caused by hepatitis B. As hepatitis B is not a hereditary disease,Prof. Chang is also curious about the mechanisms behind the transmission of liver cancer from mother to child. Her team's work has recently revealed that the newborns of mothers that carry the hepatitis B virus face a liver cancer risk 30 times that of children born to healthy mothers.
Relying on immunoglobulin and vaccinations, Taiwan has succeeded in preventing hepatitis in 90% of births. Nonetheless, Prof. Chang says, "This rate of failure is too high. I hope it can be eradicated completely." Her team is presently developing a drug for pregnant women with hepatitis B. It is administered during the third trimester (30-32 weeks) because the vertical transmission of the diseasetransmits through bodily fluid, and not the placenta, mostly during this period.
In addition to leading world-class research, Prof. Chang also invented the world's first screening system for biliary atresia in newborns. Promoted through government agencies, the system allows new parents to compare the color of their infant's feces against a feces identification card in order to determine whether their newborn is displaying signs of biliary atresia. Over the years, this system has greatly improved the survival rate of babies suffering from biliary atresia.
Academic Awards
Outstanding Research Award, National Science Council (4 times; 1990, 1992, 1995, 1997)
The Marvin L. Dixon Memorial Visiting Professorship, Harvard Combined Program in Pediatric Gastroenterology and Nutrition (1997)
Special Contract Researcher Award, NSC (2 times; 1999-2001, 2002-2004)
International Science Index Citation Classic Award (2001)
Sheila Sherlock Award, International Association for the Study of the Liver (2002)
Outstanding Achievement in Science and Technology Award, Executive Yuan (2005)
Academic Award, Ministry of Education (2006)
National Chair Professor of Medicine, Ministry of Education (2010-2012)

Academic and Administrative Background
Research physician, Department of Pediatric Gastroenterology, University of California (1981)
Visiting Professor, Laboratory of Experimental Carcinogenesis, National Cancer Institute, National Institute of Health, U.S.A. (2004)
Assistant Professor, Department of Pediatrics, NTU College of Medicine (1985-1990)
Professor, Department of Pediatrics, NTU College of Medicine (1990-present)
Director, Hepatitis Research Center, NTU Hospital (2009-present)

Special Experiences
Authoring Taiwan's first academic research article on abdominal ultrasonography
Serving as the first female chairperson of the Department of Pediatrics at NTU Hospital
Establishing the Gastroenterology and Hepatology Division at NTU Hospital's Department of Pediatrics
Establishing the Taiwan Childrens Liver Foundation

Question and Answer
What is the accomplishment of which you are the most proud?
Conducting the epidemiological survey of childhood hepatitis before the comprehensive implementation of the national hepatitis B vaccination program. The results of this survey came to stand out as a rare compilation of public health research data in the world. I thinkluck and hard work were both important to this accomplishment.
How does one maintain a habit of innovation?
You must sustain the desire and motivation to solve problems and rely on passion to overcome fear.
How do you strike a balance between family and career?
Working women are forever burning the candle at both ends. It is more difficult to succeed in research for women than it is for men. The most important thing is the support and understanding of one's family.
What are your feelings regarding the work of preventing hepatitis B?
I feel my colleagues and I are like missionaries. We need to constantly promote the concept of prevention.