Sickle Cell Anaemia (SCA)

Context:  In the budget speech, Finance Minister said that the government will work in “mission mode” to eliminate Sickle cell anaemia (SCA) by 2047.

About Sickle Cell Anaemia (SCA)

• It is one of a group of inherited disorders known as sickle cell disease. It affects the shape of red blood cells (RBC), which carry oxygen to all parts of the body.
• Cause: 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 distort it to look like a sickle.
• Impact on RBC: 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.
• Impact of SCA: 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.

India and Sickle Cell Anaemia (SCA)

• India is the second-worst affected country in terms of predicted births with SCA — i.e. chances of being born with the condition.
• Prevalence of haemoglobinopathies is more common among tribal populations than non-tribal communities in India.
  • Haemoglobinopathy is a group of disorders in which there is abnormal production or structure of the haemoglobin molecule.
  • It is passed down through families (inherited).
  • This group of disorders includes haemoglobin C disease, haemoglobin S-C disease, sickle cell anaemia, and thalassemias.
• SCA is prevalent in communities residing in areas where malaria is endemic.
  • Research has found that those with sickle red blood cells were more likely to survive malaria.
• In India, prevalence of SCA is higher in communities that practice endogamy, as the chances of having two parents with sickle cell trait are higher.

Treatment for SCA

• Gene therapy: The DNA inside the haemoglobin gene is edited to stop the disease.
• 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.

Steps Taken in India to Tackle SCA

• 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.
• National Health Mission guideline on Haemoglobinopathies 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.
• 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.
• 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.

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