Thalassemia is the commonest single gene disorder in Sri Lanka. Government
sponsored palliative care accumulate caseload leading to escalation of the
health budget. Therefore prevention has become mandatory. Lack of facilities for
antenatal diagnosis and the legal sanctions of abortions kept the nation away from
adopting the policy of terminating the affected pregnancies which is the wellestablished
A mechanism for constant motivation and monitoring should
be put in place for thalassemia prevention as has been done
for other community based prevention programs. Educational
programs should be strengthened further targeting primary
health care workers, first contact doctors and all the staff
of outpatient departments. Enhancing the current teaching
about the scientific basis of thalassemia prevention in school
curriculum is underway. However compulsory screening and
counseling seems a reasonable policy considering the possible
risk of thalassemia carries living in society with high prevalence of
thalassemia. Systems of monitoring at regional and national level
should include multiple indicators such as thalassemia screening
coverage in the community, incidence of at risk marriages, at risk
pregnancies and births of new affected cases would be valuable
indicators of monitoring the prevention program. Establishing a
national thalassemia register and referral center for evaluating
complicated problems and cases with borderline HbA2 values
would be an essential steps for future progress.