How is India addressing sickle cell Anemia?
- Sickle cell anemia (SCA), a genetic blood disorder, found mention in the Budget this year. The government will work in “mission mode” to eliminate the condition by 2047.
- India is the second-worst affected country in terms of predicted births with SCA — i.e. chances of being born with the condition
Sickle cell anemia:
- Haemoglobin, which is tasked with carrying oxygen to all parts of the body, has four protein subunits — two alpha and two beta. In some people, mutations in the gene that creates the beta subunits impact the shape of the blood cell and distorts it to look like a sickle.
- A round red blood cell can move easily through blood vessels because of its shape but sickle red blood cells end up slowing, and even blocking, the blood flow.
- Moreover, sickle cells die early, resulting in a shortage of red blood cells that deprive the body of oxygen.
- These obstructions and shortages may cause chronic anemia, pain, fatigue, acute chest syndrome, stroke, and a host of other serious health complications.
- Without treatment, quality of life is compromised and severe cases can become fatal in the initial years of life.
Does SCA only affect some:
- Research and screening programmes have found that the prevalence of haemoglobinopathies — disorders of the blood — is more common among tribal populations than non-tribal communities in India.
- Research has shown that SCA is prevalent in communities residing in areas where malaria is endemic.
- Around the middle 1940s, doctors found that those with sickle red blood cells were more likely to survive malaria.
- Those with the trait in some African countries were found to be potentially resistant to lethal forms of malaria and had a survival advantage.
- The sickle cell trait thus gave an evolutionary advantage, offering immunity to some people during malaria epidemics.
- In India, States and UTs with tribal populations contribute a significant malaria case load. Additionally, the documented prevalence of SCA is higher in communities that practice endogamy, as the chances of having two parents with sickle cell trait is higher.
- Sickle cell anemia is a genetic disorder, making complete “elimination” a challenge that requires major scientific breakthroughs.
- The only cure comes in the form of gene therapy and stem cell transplants — both costly and still in developmental stages.
- Blood transfusion, wherein red blood cells are removed from donated blood and given to a patient, is also a trusted treatment in the absence of permanent cures.
- But challenges include a scarcity of donors, fears around safe supply of blood, risk of infection etc.
What has India done so far:
- The Indian Council of Medical Research and the National Rural Health Mission in different States are undertaking outreach programmes for better management and control of the disease.
- The Ministry of Tribal Affairs launched a portal wherein people can register themselves if they have the disease or the trait, in order to collate all information related to SCA among tribal groups.
- In the Budget, the Union Health Minister said the government plans to distribute “special cards” across tribal areas to people below the age of 40.
- “The cards will be divided into different categories based on the screening results..” The mission will receive funding under the National Health Mission.