MANAGE OR CURE?

Dr Jennifer Geel, a paediatric oncologist at the Charlotte Maxeke Academic Hospital, says: “We have a clinic with more than 400 active patients at our hospital. We treat these children with regular antibiotics and supplements and encourage them to keep themselves healthy by drinking lots of water, getting infections treated early and avoiding extremes of temperature (neither too hot nor too cold).”

One way potentially to cure the disease is to replace all the bone marrow in a patient’s body with donor stem cells, which can grow into new bone marrow and make new, healthy red blood cells. But the procedure is still new, risky, and complex, requiring a long and traumatic course of chemotherapy and hospital stay.

“Our health system is under enormous financial strain,” says Dr Geel. “Stem cell therapy offers a cure, but in South Africa it is prohibitively expensive at more than R1 million per bone marrow transplant. Blood and platelet requirements alone can’t be met with current demand – transplanting all these patients is not possible.”

Advances in treatment mean that scientists now know which specific gene mutation causes sickle cell anaemia. Replacing the faulty gene is another possibility for curing the disease in the future. Says Dr Geel: “Gene therapy has been done successfully in the US, but it’s not yet an option here.”