• Prime Minister Narendra Modi launched National Sickle Cell Anaemia Eradication Mission (NSCAEM) 2047.

• At a function held at Shahdol in Madhya Pradesh, the PM distributed Sickle Cell colour-coded counselling cards to a few beneficiaries. He also handed over Ayushman cards and PVC Ayushman Bharat cards physically to some beneficiaries.

• The National Sickle Cell Anemia Eradication Mission (NSCAEM), which aims to address the pressing health challenges posed by sickle cell disease, particularly among the tribal population, was announced in the Union Budget 2023.

• This mission will be implemented in 278 districts of 17 states. 

• The 17 states are: Gujarat, Maharashtra, Rajasthan, Madhya Pradesh, Jharkhand, Chhattisgarh, West Bengal, Odisha, Tamil Nadu, Telangana, Andhra Pradesh, Karnataka, Assam, Uttar Pradesh, Kerala, Bihar and Uttarakhand.

• The programme is executed in a mission mode as part of the National Health Mission (NHM), aims to eliminate sickle cell genetic transmission by the year 2047, showing a long-term commitment to eradicating the disease.

• Over a period of three years, the programme targets screening approximately 7 crore people.

• This ambitious goal highlights the programme’s objective to reach a large portion of the population, promote early diagnosis and intervention.

Sickle Cell Disease

• The haemoglobinopathies are a group of disorders passed down through families (inherited) in which there is abnormal production or structure of the hemoglobin molecule.

• Approximately 5 per cent of the world’s population carries trait genes for haemoglobin disorders, mainly, sickle-cell disease and thalassaemia. 

• Over three lakh babies with severe haemoglobin disorders are born each year globally.

• Sickle Cell Disease (SCD) is one such blood disorder caused by the abnormal haemoglobin that damages and deforms red blood cells.

• 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”. 

• The sickle cells die early, which causes a constant shortage of red blood cells. Also, when they travel through small blood vessels, they get stuck and clog the blood flow. This can cause pain and other serious complications.

• The disorder requires lifelong management and contributes to infant and childhood morbidity and mortality. SCD is caused by inheritance of two abnormal HbS genes, one from each parent or HbS gene from one parent and HbE or β thalassemia  gene from the other. 

• Sickle cell syndromes include Sickle Cell Disease (SCD, HbSS), also called Sickle Cell Anaemia (SCA), as well as disorders due to sickle cell gene combined with another hemoglobinopathy such as Hb C, E, or β thalassemia.

• Persons carrying only one of these genes are called ‘carriers’ as they do not suffer from any disease but carry the abnormal gene and transmit it to the next generation. Carriers cannot be recognised clinically, but only by performing special blood tests. Where both mother and father are ‘carriers’, there is a chance that their children may inherit the abnormal gene from both parents.

National Sickle Cell Anemia Eradication Mission 2047

• Sickle cell disease is more common in the tribal population of India.

• India has the largest density of tribal population, globally. As per Census 2011, India has an 8.6 per cent tribal population.

• A report by the health ministry has listed sickle cell disease as one of the 10 special problems in tribal health that affect the tribal people disproportionately, thus making this an important intervention. 

• The ministry of health under National Health Mission initiated the work on hemoglobinopathies (Thalassemia & Sickle Cell Disease) in 2016 wherein comprehensive guidelines on prevention and management of heamoglobinopathies were released and provision of funds towards screening and management of Sickle Cell Disease were made. However, the pandemic reduced the efforts towards prevention through screening and information, education & communication (IEC) activities.

• So, a separate mission has been launched to improve care of all Sickle Cell Disease patients for their better future and to lower the prevalence of the disease through multi-faced coordinated approach towards screening and awareness strategies.

• It aims to eliminate SCD as a public health problem in India before 2047. 

• It will enable access to affordable and quality health care to all SCD patients, and lower the prevalence through awareness, change of practices and screening interventions.

Objectives of the Mission:

i) Provision of affordable and accessible care to all SCD patients.

ii) To ensure quality of care for SCD patients.

iii) To reduce the prevalence of SCD.

These objectives would be attained through strategies spanning:

• Awareness generation.

• Strengthening of screening and testing facilities.

• Strengthening of laboratory services for diagnosis.

• Facilitation of management & treatment.

• Inter-sectoral convergence towards holistic approach.

• Linkages with social security schemes/benefit packages. 

Strategy

The strategy emphasizes on three pillars:

i) Health promotion - Awareness generation & pre-marital genetic counselling.

ii) Prevention: Universal screening and early detection.

iii) Holistic management & continuum of care-

a) Management of persons with sickle cell disease at primary, secondary and tertiary health care levels; treatment facilities at tertiary health care facilities.

b) Patient support system.

c) Community adoption.

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