Beta-thalassemia is the commonest, serious, single-gene disorder in Pakistan. The psychosocial and financial burden placed on affected persons and families is treatment, as is the cost of treatment for the health services, which exceeds Rupees 3.5 billion annually for a national caseload of approximately 8000 patients. Preventing this hereditary disorder is therefore a priority. 

Screening programs were an essential component of preventive strategies in countries that effectively reduced birth prevalence of beta-thalassemia. With termination of pregnancy not legally permissible in Pakistan, prenatal diagnosis and selective abortion is not possible. Instead, the concept of “safe marriages” has been adopted. A “safe marriage” is defined as a union where at least one partner is not a carrier. 

This strategy involves voluntary community participation for premarital screening of carrier status. Imitating astrological consultation to assess compatibility of marriage partners, a cultural practice widely used in the region, this new strategy enables individuals to assess medical compatibility. This would reduce “at-risk” marriages and the possibility of giving birth to an affected offspring. The community based health education program uses pictorial depiction of non-compatibility of carrier-carrier marriages as well as carrier marriages with those who have not tested in a similar manner to an astrological method. 

For the campaign to be effective, there must be screening in people of 15-49 years of age. A governmental policy could prove beneficial in averting this fatal but preventable disorder. This way, Pakistan can increase its life expectancy and also decrease financial burden on the health sector. 

HANIF SHAR,  

Karachi, May 4.