Sickle cell anaemia (SCA), a genetic blood disorder, found mention in the Budget this year. Finance Minister Nirmala Sitharaman said that the government will work in mission mode to eliminate the condition by 2047.


What is Sickle Cell Anaemia (SCA)?

  • First discovered by a physician named James Herrick, Sickle cell anaemia is one of a group of inherited disorders known as sickle cell disease (SCD).
  • It affects the shape of red blood cells, which carry oxygen to all parts of the body.
  • Red blood cells contain haemoglobin, a protein that carries oxygen. Healthy red blood cells are round, and they move through small blood vessels to carry oxygen to all parts of the body.
  • In someone who has SCD, the haemoglobin is abnormal, which causes the red blood cells to become hard and sticky and look like a C-shaped farm tool called a sickle.


What happens in SCA?

  • 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 anaemia, pain, fatigue, acute chest syndrome, stroke, and a host of other serious health complications.


Can it be treated?

  • Sickle cell anaemia is a genetic disorder, making complete elimination a challenge that requires a major scientific breakthrough.
  • The only cure comes in the form of gene therapy and stem cell transplants — both costly and still in developmental stages.
    • In gene therapy, the DNA inside the haemoglobin gene is edited to stop the disease.
    • In stem cell transplants, the bone marrow affected by sickle cell anaemia is replaced with healthy bone marrow from a donor.
  • 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.


Status in India

  • India is the second-worst affected country in terms of predicted births with SCA — i.e., chances of being born with the condition. In India, around 18 million people have sickle cell traits and 1.4 million patients have sickle cell disease.
  • Sickle Cell Disease (SCD) is widespread among the tribal population in India where about 1 in 86 births among STs have SCD.
  • A few states in India have a significantly higher SCD prevalence. These include: Chhattisgarh, West Bengal, Uttar Pradesh, Maharashtra, Madhya Pradesh, Jharkhand, Gujarat, Odisha, Kerala and Rajasthan.
  • Collectively, these states are referred to as the sickle cell belt.


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 (MoTA) has launched the Sickle Cell Disease Support Corner to bridge the gap between patients and health care services in tribal areas.
      • The Portal provides a web-based patient powered registration system which will collate all information related to SCD among tribal people in India.
      • This includes providing them a platform to register themselves if they have the disease or the trait.
      • The National Council on Sickle Cell Disease has also been constituted for timely and effective action.
  • The National Health Mission guideline on Hemoglobinopathies also identifies establishing services at the community level for pre-marital and pre-conception screening backed by genetic counselling services as a strategy for addressing SCA.
  • In the Budget 2023-24, the government announced its 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.