Maharashtra sees steady decline in new thalassemia cases amid push for universal screening

Pune: Maharashtra’s battle against thalassemia is yielding results, with new cases seeing a steady decline over the last five years. State health department data reveal a consistent drop in new patients from 725 in 2021, 628 in 2022, 566 in 2023, 552 in 2024 to 458 in 2025.Experts and officials attribute this success to a combination of free bone marrow matching campaigns, state-sponsored transplants, and shift toward early prevention.The primary factor behind the falling numbers is the state’s aggressive push for bone marrow transplants (BMT), currently the only known cure for the condition. Dr Suhas Mohnalkar, deputy director of haemoglobinopathy for state health services, said that the state has sponsored BMTs for 90 children in the past year alone.“Our efforts are bearing fruit,” said Dr. Mohnalkar. “Through the CM Relief Fund and insurance schemes like Mahatma Jyotirao Phule Jan Arogya Yojana and Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana, the state provides between Rs9.5 lakh and Rs17 lakh per transplant. By treating existing patients through BMT, we are reducing the overall burden on the healthcare system.”Beyond treatment, the state is focusing on cutting off the transmission of the gene. Last month, a high-level 11-member committee was formed to draft a proposal mandating high-performance liquid chromatography (HPLC) tests for every pregnant woman. This test allows for the early diagnosis of a thalassemic fetus, giving couples the option of medical termination to avoid the birth of a “thalassemia major” child.To bridge the gap between patients and donors, the health department has conducted free bone marrow cross-matching campaigns under the “Vision 2025: Thalassemia Free Bharat Programme” in cities like Pune, Chhatrapati Sambhajinagar, and Nanded.“We have also instructed matrimonial agencies to educate couples on the importance of undergoing thalassemia tests before marriage,” said Laxmikant Pimpalgaonkar, the state coordinator for the programme. District health officials have been further directed to ensure that chelation medicines are fully stocked at the district level using DPDC funds.Despite the decline, data shows a high concentration of patients in cities. Mumbai leads with 3,420 patients, followed by Pune (1,501) and Nagpur (650). Dr. Mohnalkar said that while consanguineous marriages (marriages within the same bloodline) were historically the primary cause, migration has now concentrated carriers in Tier-1 cities.State health minister Prakashrao Abitkar emphasised that mandatory screening is the next logical step. “Screening and awareness are often inadequate, leading to late diagnoses. We will soon make thalassemia screening mandatory to ensure these numbers continue to shrink,” he said.“As of now, a bone marrow transplant remains the only definitive cure for thalassemia, which is a highly expensive procedure. In comparison, testing is remarkably affordable,” said Dr Kannan Subramanian, senior hemato-oncologist at KEM Hospital, Pune. He said, “The cost of a bone marrow transplant can be around Rs 12 lakh, while the detection cost—a simple blood test called hemoglobin electrophoresis—is barely Rs 1,000. Thalassemia minor carriers are asymptomatic and do not require treatment. However, they remain carriers for life and can unknowingly pass on the gene. Once a thalassemic fetus is diagnosed, both partners can be counseled, and the birth of a thalassemia major child can be prevented through medical termination.”“The need of the hour is widespread awareness, mandatory carrier screening, counseling, and access to prenatal diagnostic services as essential steps to curb new cases,” added Dr Nita Munshi, president of the Thalassemia Society, Pune Chapter. She said, “Children born with thalassemia major often face a lifetime of regular blood transfusions and iron chelation therapy, placing immense emotional, psychological, and financial strain on families.”