Thalassaemia prevention in Asia: progress, challenges, and future directions.

Thalassaemia remains a major public health burden in Asia, where high carrier frequencies, diverse mutation spectra, and variable healthcare capacity continue to influence disease prevention and control. This Series paper summarises the status of thalassaemia prevention programmes across 14 Asian countries and highlights the key challenges and opportunities affecting their implementation. Singapore, Malaysia, the Maldives, and Thailand have established the most structured prevention strategies, incorporating combinations of public awareness, carrier screening, genetic counselling, and prenatal diagnosis, with measurable success most clearly demonstrated in Singapore and, to a specific extent, Thailand. In contrast, many other countries in the region continue to face fragmented services, limited national coordination, shortages of trained personnel, inadequate epidemiological data, and financial, technological, cultural, and social barriers. Differences in prevention efforts broadly reflect wider disparities in health system development. Strengthening national prevention programmes should be viewed as both a public health priority and a cost-effective investment in reducing long-term disease burden.