The National Sickle Cell Anaemia Elimination Mission is a Government of India initiative launched to eliminate sickle cell disease as a public health problem by 2047.
It was announced in the Union Budget 2023–24 and formally launched by the Prime Minister on 1 July 2023 from Shahdol, Madhya Pradesh. The mission mainly focuses on tribal and high-burden areas where sickle cell disease is more common.
What is Sickle Cell Disease?
Sickle Cell Disease (SCD) is an inherited blood disorder. In this condition, red blood cells become sickle-shaped instead of round and flexible.
Normal red blood cells move easily through blood vessels. But sickle-shaped cells are stiff and can block blood flow. This can cause severe pain, anaemia, infections, organ damage and repeated hospitalisation.
The disease is inherited. If both parents carry the sickle cell gene, the child has a risk of being born with sickle cell disease. This is why screening, counselling and genetic status cards are central to the mission.
Objective of the Mission
The mission aims to reduce the burden of sickle cell disease through early detection, counselling, treatment and long-term care.
Its main objectives are:
- screen vulnerable populations for sickle cell disease and carrier status
- provide genetic counselling to affected families
- distribute sickle cell genetic status cards
- ensure early diagnosis and treatment
- improve access to care in tribal and remote areas
- create awareness before marriage and pregnancy
- reduce transmission of the disease to future generations
- eliminate sickle cell disease as a public health problem by 2047
The mission targets screening of approximately 7 crore people under 40 years of age in about three years.
Latest Screening Data
The mission has made major progress in screening.
As of 22 July 2025, India had screened 6 crore individuals for sickle cell disease against the target of 7 crore. Among those screened, 2.15 lakh people were diagnosed with sickle cell disease, and 16.7 lakh carriers were identified.
A later government update stated that as of 31 July 2025, a total of 6,07,30,111 screenings had been completed in the 17 identified tribal-dominated states. The approved cost norm for screening is ₹100 per person, covering screening, record keeping and related costs.
Coverage
The mission is being implemented in 17 high-burden states, especially tribal-dominated regions.
These include states with significant tribal populations and known sickle cell prevalence, such as Madhya Pradesh, Gujarat, Maharashtra, Odisha, Chhattisgarh, Jharkhand, Rajasthan, Telangana, Andhra Pradesh, Karnataka, Kerala, Tamil Nadu, Uttar Pradesh, West Bengal, Bihar, Assam and Uttarakhand.
The focus is not only on diagnosis, but also on building a community-based prevention and care system.
How the Mission Works
The mission uses a combination of screening, digital records, counselling and treatment linkage.
The process generally includes:
- community mobilisation in high-risk areas
- screening through health camps, schools, anganwadis, health centres and Ayushman Arogya Mandirs
- point-of-care testing and confirmatory diagnosis
- identification of patients and carriers
- issuing genetic status cards
- counselling families about inheritance risk
- linking patients with treatment and follow-up care
- maintaining digital records through the national sickle cell portal
The Ministry has also approved screening technologies. As of July 2025, 30 Point-of-Care Tests and 5 non-Rapid Diagnostic Test assays validated by ICMR had been approved for screening.
Genetic Status Cards
One of the important features of the mission is the distribution of sickle cell genetic status cards.
These cards show whether a person is:
- normal
- a carrier/trait holder
- affected by sickle cell disease
This is important because a carrier may not show serious symptoms but can pass the gene to children. If two carriers marry, their child has a higher risk of being born with sickle cell disease.
The cards are meant to support informed marital and reproductive decisions, especially in communities where the disease burden is high.
Why Tribal Areas Are the Focus
Sickle cell disease is more common among several tribal communities in India. The disease creates a serious health and livelihood burden because patients may suffer from repeated pain crises, weakness, infections, poor growth, school absenteeism and reduced work capacity.
In remote tribal regions, the problem becomes worse due to:
- limited diagnostic facilities
- poor access to specialists
- low awareness
- late diagnosis
- weak follow-up care
- shortage of blood transfusion facilities
- distance from hospitals
That is why the mission combines screening with counselling, treatment access and awareness generation.
Treatment and Care
Sickle cell disease cannot be managed only through one-time screening. Patients need long-term care.
Important care measures include:
- regular medical follow-up
- pain crisis management
- infection prevention
- folic acid supplementation
- hydroxyurea where clinically appropriate
- blood transfusion support in severe cases
- vaccination and preventive care
- counselling for families
- referral for complications
Some states are also creating specialised facilities. For example, Gujarat received approval for its first Centre of Competence for sickle cell anaemia in Surat, with a proposed budget of ₹6 crore, aimed at comprehensive patient care, training and research.
Digital and Institutional Support
The mission uses a digital-first approach through the national sickle cell portal. The portal helps record screening data, track diagnosed cases, maintain genetic status information and support follow-up.
This is important because sickle cell disease requires long-term monitoring. Without digital records, patients may be screened once but lost to follow-up.
The mission involves coordination between:
- Ministry of Health and Family Welfare
- Ministry of Tribal Affairs
- National Health Mission
- state health departments
- district hospitals
- Ayushman Arogya Mandirs
- schools and anganwadis
- community health workers
- tribal welfare departments
Significance
The mission is important because it treats sickle cell disease not only as a medical issue, but also as a public health, tribal welfare and social justice issue.
Its significance lies in:
- early detection of affected persons
- identification of carriers before marriage or pregnancy
- reduction of disease transmission across generations
- better treatment access in tribal regions
- improved quality of life for patients
- reduced out-of-pocket expenditure
- stronger genetic disease surveillance
- integration of tribal health with public health systems
The scale is also significant: screening 7 crore people for a genetic blood disorder is one of India’s largest targeted public health screening efforts.
Challenges
The mission has made strong progress in screening, but elimination will depend on follow-up care.
Screening alone does not reduce disease burden unless patients receive treatment, counselling and long-term monitoring.
Major challenges include:
- ensuring confirmatory testing after initial screening
- avoiding loss to follow-up
- shortage of haematologists and trained counsellors
- limited availability of advanced diagnostic facilities in remote areas
- ensuring regular supply of hydroxyurea and essential medicines
- improving blood transfusion access
- counselling without stigma or discrimination
- integrating genetic counselling with community customs
- maintaining data quality in digital records
- ensuring that carriers understand reproductive risk
A 2025 report from Jharkhand highlighted gaps such as limited HPLC-based testing in many districts, absence of genetic testing and fetal medicine facilities in government hospitals, and supply/monitoring issues related to hydroxyurea.
State-Level Example: Odisha
Odisha shows the scale of the disease burden in high-risk states.
Between July 2023 and August 2025, Odisha screened 46.65 lakh people and identified 97,501 sickle cell disease cases and 4.11 lakh sickle cell trait cases. Screening was being carried out across schools, anganwadi centres, antenatal care visits, mobile health units and Ayushman Arogya Mandirs.
This shows why the mission needs both mass screening and long-term district-level treatment systems.
Way Forward
The mission should now move from screening-heavy implementation to a complete care model.
India needs stronger district-level treatment pathways, trained counsellors, reliable confirmatory testing, medicine availability, blood transfusion support and patient follow-up. Community-level awareness is equally important because the disease is inherited and prevention depends on understanding carrier status.
The mission will succeed only when every screened patient is connected with care, every carrier receives counselling, and every high-burden district has the capacity to diagnose, treat and track sickle cell disease over time.
