Sickle Cell Anaemia: A Tribal Health Crisis in India

Context:

This analysis highlights the challenges of sickle cell anaemia (SCA) among tribal communities in Andhra Pradesh’s Alluri Sitharama Raju district, focusing on personal stories and the broader public health response. The piece underscores the genetic burden of SCA and India’s efforts to address it, particularly through government initiatives, making it a vital topic for understanding health policy, tribal welfare, and national disease elimination strategies.

1. SCA Prevalence: A genetic blood disorder, SCA affects tribal areas like Alluri Sitharama Raju district, with many children diagnosed, reflecting its high incidence among India’s tribal populations.
2. Health Impact: Causes crescent-shaped red blood cells, leading to pain, infections, and organ damage; K. Praveen’s sister suffered for 15 years before dying in September 2024, showing its severity.
3. Personal Stories: Kumar’s daughter and Praveen (diagnosed 2010) highlight SCA’s toll on families, with symptoms like fatigue and pain disrupting lives in Araku Valley.
4. National Burden: India has the world’s second-highest SCA cases after Africa, with 20-35 million carriers and significant tribal concentration in states like Andhra Pradesh.
5. Government Initiative - NSCAEM: Launched in 2023, the National Sickle Cell Anaemia Elimination Mission aims to eradicate SCA by 2047, targeting screening of 7 crore people aged 0-40 in tribal areas.
6. Screening Efforts: Over 4.8 crore screenings completed by March 2025 (per posts on X), with Andhra Pradesh testing schoolchildren and pregnant women annually; a major drive occurred in 2024.
7. Medical Support: NSCAEM provides care in 278 districts across 17 tribal-heavy states, including Andhra Pradesh, focusing on early detection and treatment to reduce mortality.
8. Challenges: Stigma, poverty, and limited healthcare access in remote tribal regions hinder progress, as seen in delayed diagnoses and treatment dropouts in Araku Valley.
9. Policy Focus: Integrates with PM JANMAN to empower tribals, emphasizing awareness, counseling, and genetic screening to break the cycle of inheritance.

Key Terms:

• Sickle Cell Anaemia (SCA): Genetic disorder causing abnormal, sickle-shaped red blood cells.
• NSCAEM: National Sickle Cell Anaemia Elimination Mission, aiming for SCA eradication by 2047.
• Tribal Communities: Indigenous groups, often SCA-affected, targeted for health interventions.
• Genetic Screening: Testing to identify SCA carriers and prevent transmission.
• PM JANMAN: Scheme empowering tribal development, linked to health missions.
• Carrier: Individual with one SCA gene, at risk of passing it to offspring.
• Haemoglobin: Protein in red blood cells, mutated in SCA, affecting oxygen transport.