Is a national program to prevent sickle cell disease possible?

There is no specific therapy for sickle cell disease, and there is no evidence that sickle hemoglobin screening by conventional methods will lead to a significant reduction in the number of children with sickle cell disease. Thus it follows that if there is to be a national program to prevent sickle cell disease, the only recourse is one based on prenatal diagnosis and selective abortion of affected embryos or fetuses. Present-day dire poverty and callous health care public policies lead to the inescapable conclusion that a concerted attempt to alleviate poverty and its consequent adverse effects on maternal, neonatal, and infant mortality should take precedence over, or at the least coincide with, a national program to prevent sickle cell disease. On the other hand, it is argued that a woman should have the right to decide whether or not she wishes to have a child with a genetic disorder, and that recent advances in research on prenatal diagnosis, particularly when supported by public funds, should be made available to all, and not just the affluent.