Sickle Cell Cure: See the country where treatment is free

PULSE

Around 2% to 3% of the Nigerian population has sickle cell disease (SCD), while about 25% of Nigerians carry the sickle cell trait, making it a major public health concern.

What is Sickle Cell Disease?

Sickle Cell Disease (SCD) is a genetic blood disorder that affects red blood cells, causing them to take on a sickle or crescent shape. Unlike normal round red blood cells that flow smoothly through blood vessels, sickled cells can stick together and block blood flow, leading to severe pain (sickle cell crisis), anaemia, organ damage, and other life-threatening complications.

Despite its high prevalence, many Nigerians struggle to access quality care, as healthcare facilities often lack specialized treatment and standard-of-care practices for SCD management.

Sickle Cell Cure: Bone Marrow Transplant

For years, sickle cell disease was considered a lifelong condition, but recent advances in medicine have introduced a potential cure which is bone marrow transplants. This procedure involves taking healthy bone marrow from a donor and transplanting it into the recipient, allowing the body to produce normal red blood cells instead of sickled ones.

However, the cost of this treatment remains a major barrier for many in Nigeria. A bone marrow transplant costs approximately $2 million (₦3 billion), making it unaffordable for most families.

Conversely, this treatment has been made free in the United Kingdom, giving patients access to a cure without financial hardship.

The bone marrow (stem cell) transplant is generally free on the National Health Service (NHS) for eligible patients, as the service covers the cost of medically necessary treatments.

However, there are some factors to consider:

• The transplant must be deemed medically necessary (e.g., for leukaemia, lymphoma, sickle cell disease, etc.).
• Patients may need to meet certain eligibility criteria based on their condition.
• While the treatment itself is free, there may be indirect costs such as travel, accommodation (if treatment is far from home), and loss of income during recovery.

Bone marrow (stem cell) transplants for SCD patients

Some eligibility criteria that may be considered before free treatment include:

• Severity of Disease: The transplant is typically considered for patients with severe sickle cell disease that significantly impacts their quality of life and has not responded to other treatments.
• Suitable Donor: A matched sibling donor is often required for the procedure. However, with medical advancements in gene-editing therapies, this may soon become a thing of the past.

Half bread better than none

While the criteria for free treatment may be stringent, the possibility of a pain-free life is a mouth-watering proposition for sickle cell warriors.

However, in Nigeria, the outlook is stark especially as the country holds the highest sickle cell burden globally.

150,000 to 200,000 babies are born with this condition annually and studies estimate that between 50% to 80% of these children die before reaching the age of five. Furthermore, the financial burden of managing SCD in Nigeria is substantial.

Monthly treatment costs can reach up to ₦1,000,000, placing immense strain on affected families. Additionally, the chronic nature of SCD leads to ongoing medical expenses, further exacerbating the economic challenges faced by patients and their caregivers.

This raises the question: Can Nigeria also make this treatment free or at least subsidized? Addressing sickle cell disease requires urgent action, starting with improving access to comprehensive care and advocating for affordable or free bone marrow transplants, just like in the UK.

The urgent need for better healthcare policies and affordable treatment options for SCD patients in Nigeria cannot be overemphasised.

THIS STORY FIRST APPEARED IN PULSE