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Commentary
Time to apply a social determinants of health lens to addressing sickle cell disorders in sub-Saharan Africa
  1. Maria Berghs1,
  2. Bola Ola2,
  3. Anna Cronin De Chavez3,
  4. Bassey Ebenso3
  1. 1Unit for the Social Study of Thalassaemia and Sickle Cell, School of Allied Health Sciences, De Montfort University, Leicester, UK
  2. 2Department of Psychiatry, Faculty of Clinical Sciences, Lagos State University, Lagos, Nigeria
  3. 3Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, UK
  1. Correspondence to Bassey Ebenso; b.e.ebenso{at}leeds.ac.uk

https://doi.org/10.1136/bmjgh-2020-002601

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    Summary box

    • Sickle cell disorders are a complex multisystem inherited genetic blood disorders that affect millions of people worldwide and complications of the disorders can include anaemia, pain episodes and organ damage.

    • Medical advances, early detection, intervention in infancy and specialised care across the life-course are transforming these genetic blood disorders into chronic conditions, with longer life expectancies and better quality of life, yet public health debates continue to view sickle cell disorders as purely biomedical problems that need to be prevented.

    • We argue that adopting a social determinants of health approach to sickle cell disorders can help to move the policy focus from viewing sickle cell disorders as burdens to be prevented, to a more holistic perspective that would ensure better health and well-being across the life-course.

    • The social determinants of health promotes a socially just and ethical framing of health and well-being in all policies, that are fundamental to achieving the United Nations Sustainable Development Goals (SDGs), including SDG 10—of reducing health inequalities within and between countries.

    Introduction

    Why do sickle cell disorders (SCDs) remain a low priority on the global child health agenda when a child dies from the condition every three seconds globally? Why are more resources not invested to save lives and ensure holistic care of people with SCDs? Why is policy focus shifting towards development of genomic cures instead of assuring better healthcare for people across the life-course? The disconnect between policy and practice raises further questions. What is the point of a cure if you live in poverty, do not have basics of healthcare and are susceptible to dying from a myriad of other diseases or during a pandemic? For many people, the major complications of inherited genetic conditions like SCDs include intractable pain, organ failure and death, that are often triggered by environmental factors such …

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