National Sickle Cell Anaemia Elimination Mission

The National Sickle Cell Anaemia Elimination Mission was launched in 2023 as a joint initiative of the Ministry of Health and Family Welfare and the Ministry of Tribal Affairs. Its goal is to eliminate sickle cell disease as a public health problem in India by 2047, aligning with the broader ‘Azadi ka Amrit Mahotsav’ vision.

Sickle cell disease (SCD) is an inherited haemoglobin disorder most prevalent among Scheduled Tribe communities in central, western and southern India. States with the highest burden include Maharashtra, Madhya Pradesh, Chhattisgarh, Gujarat, Rajasthan, Jharkhand, Odisha, Telangana, Andhra Pradesh, Karnataka, Kerala, Tamil Nadu, Assam, West Bengal, Bihar, Uttar Pradesh and Uttarakhand. The mission operates in all districts within these states where prevalence exceeds 5%.

The mission has four pillars: screening and counselling; treatment and management; awareness and community engagement; and research and surveillance. Unlike earlier sporadic programmes, this is a mission-mode approach with dedicated budgets, real-time dashboards, and convergence with the National Health Mission, Ayushman Bharat, and tribal welfare schemes.

Sickle cell disease is caused by a mutation in the beta-globin gene. A person inherits one copy of the mutated gene from each parent to develop the disease (genotype SS or S-beta-thalassaemia). A person who inherits only one mutated copy and one normal copy is a carrier, known as sickle-cell trait (genotype AS). Carriers generally do not have symptoms but can pass the gene to their children.

When two carriers marry, each child has a 25% chance of having the disease (SS), a 50% chance of being a carrier (AS), and a 25% chance of being unaffected (AA). This is why genetic counselling is central to the mission: by informing carriers of their status before marriage, the mission empowers families to make informed reproductive choices and reduce the incidence of affected births.

The mission uses a two-stage screening protocol: first, a rapid solubility test (Sickling Test) at the community level, followed by confirmatory High-Performance Liquid Chromatography (HPLC) at the district hospital or designated laboratory. Every screened individual receives a Sickle Cell Status card indicating their genotype.

Under the mission, every resident of an endemic district in the 0–40 age group is entitled to free screening. Screening camps are organised at Anganwadi centres, schools, gram panchayat buildings, and through mobile medical units (MMUs) that visit remote tribal hamlets. ASHAs and ANMs are trained to collect blood samples via finger prick and transport them to the nearest HPLC facility.

Persons diagnosed with sickle-cell disease (SS) receive free treatment including: hydroxyurea tablets (which reduce painful crises and need for transfusions), folic acid supplementation, pain management medication, penicillin prophylaxis for children, and blood transfusion at district hospitals designated as Sickle Cell Care Centres. Vaccination against pneumococcal disease, influenza, and meningococcus is also provided.

Genetic counselling is offered to all carriers (AS) and affected individuals (SS). Counsellors explain inheritance patterns, reproductive options, and the importance of partner screening before marriage. In select medical colleges, prenatal diagnosis (PND) is offered to couples at risk, allowing them to know the foetal genotype early in pregnancy.

The 17 high-focus states have established State Sickle Cell Cells under their respective State Health Missions. Each endemic district has a District Nodal Officer (DNO) who coordinates screening camps, HPLC sample transport, and linkage to Sickle Cell Care Centres. Tribal-dominated blocks receive additional mobile units and ASHA incentives for mobilising families.

Maharashtra and Madhya Pradesh have the most advanced infrastructure, with dedicated Sickle Cell Clinics at medical colleges in Nagpur, Indore and Jabalpur. Chhattisgarh and Jharkhand rely heavily on MMUs due to difficult terrain. Gujarat has integrated the mission with its existing Thalassaemia Control Programme, sharing laboratory infrastructure.

If you live in a high-burden district and have not been screened, contact your nearest Primary Health Centre (PHC) or Anganwadi centre. Ask for the ‘Sickle Cell Screening Camp’ schedule. You can also call the State Health Mission helpline or check the mission portal (sicklecellanemia.gov.in) for camp dates in your district. Screening is free, voluntary, and requires no prior appointment.

Despite the mission’s ambitious goals, implementation gaps persist. HPLC machines are scarce in smaller districts, causing long delays in confirmatory results. Many district hospitals lack trained haematologists, forcing patients to travel to state capitals for specialist care. Hydroxyurea stock-outs are reported in Chhattisgarh, Odisha and Jharkhand.

As a beneficiary, you have the right to: free screening without stigma; timely delivery of HPLC results (within 21 days); free hydroxyurea and folic acid at the nearest Sickle Cell Care Centre; and referral transport to higher centres during vaso-occlusive crises. If any of these rights are denied, file a complaint with the District Nodal Officer, the State Commissioner for Persons with Disabilities (since SCD is recognised as a disability under RPwD Act), or the National Health Mission grievance portal.

Community organisations and self-help groups of affected families are emerging in Maharashtra, Gujarat and Chhattisgarh. These groups conduct peer counselling, track medicine availability, and petition district administrations for better infrastructure. Joining or forming such a group can amplify your voice and hold the health system accountable.

• 01Resident of an endemic district in one of the 17 high-focus states
• 02Age 0–40 years (universal screening mandate)
• 03Belonging to a Scheduled Tribe, Scheduled Caste, or other high-risk community (screening is universal, but treatment prioritisation follows vulnerability criteria)
• 04No income or BPL requirement for screening; treatment is free at government Sickle Cell Care Centres
• 05Pregnant women in endemic districts are screened regardless of age

• §Aadhaar card or any government photo ID
• §Caste / tribe certificate (for tracking and programme evaluation; screening itself is universal)
• §Birth certificate or age proof (for children and adolescents)
• §Previous medical records (if already diagnosed and seeking continued treatment)
• §Ration card (for linkage to nutrition support under ICDS/NHM)

• Denial of screening on grounds of non-tribal status (screening is universal in endemic districts)
• Excessive delays in HPLC results due to laboratory backlogs
• Refusal to provide hydroxyurea at PHC level (should be available at all designated Sickle Cell Care Centres)
• Charging fees for screening or genetic counselling (both are free under the mission)
• Failure to arrange referral transport during painful crises (districts must have emergency transport protocols)

• National Sickle Cell Anaemia Elimination Mission Guidelines, Ministry of Health & Family Welfare / Ministry of Tribal Affairslink ↗
• ICMR Screening Protocol for Sickle Cell Disease, Indian Council of Medical Researchlink ↗
• State-wise Sickle Cell Burden and Action Plan, NIRTH / MoHFWlink ↗
• Rights of Persons with Disabilities Act 2016 and SCD Recognition, Department of Empowerment of Persons with Disabilitieslink ↗