Prevention
A carrier test costs us ₹350 and reaches the family free. The condition it looks for takes 38.8% of a household’s income every year, for as long as the child lives. That arithmetic is the easy part of this page. The hard part is everything that has to happen after the test.
The arithmetic
₹350
Gupta et al., 2025
One carrier test
₹350
One lifetime
₹20,00,000
Drawn to scale, the whole bar is one life with transfusion-dependent thalassemia: ₹20 lakh in direct treatment, and 38.8% of a household’s income every year, for as long as the child lives. The sliver at the left is the test.
Source: Moirangthem and Phadke, 2018
The cliff
In one Punjab teaching hospital, 27 couples were identified as at risk. 19 completed diagnosis.
8 of 27
never completed diagnosis. Not one of them because the laboratory failed.
Why the 8 did not
Five reasons for eight families, and no count per reason: the evaluation does not report one, so neither do we.
A third of partners never came in. 43% of women first presented in the second or third trimester.
Source: Mashon et al., 2024; Bhukhanvala et al., 2012; Colah et al., 2008
Same test, same disease, same country. Surat, Gujarat returned 5.7 : 1 against the ₹20 lakh a birth averted costs; a seven-year multi-site evaluation returned 0.4 : 1. The laboratory does not explain that. How many identified couples were carried through to a decision explains all of it.
Source: Mashon et al., 2024; Bhukhanvala et al., 2012; Colah et al., 2008
It has been done
85%
Cao and Kan, 2013
Population carrier screening, counselling for every carrier, a hub-and-spoke laboratory network. The strategy is settled. What does not exist is the system that carries a family through it.
Your turn
The prevention happens months later, in a conversation with a partner who has not yet been tested, or in a decision a family makes while there are still options. We do not tell a family what to decide, and nothing here is a verdict on the choice they make. What we owe them is knowledge, counselling, and options while there is still time.
Ready?
Fund a round of screening, or book a carrier test.