In Jamaica, sickle cell disease is a public health issue. Approximately, 1 in 150 births are diagnosed with sickle cell disease. In the past, Jamaica has been the focus of studies on the disease due to its population(http://www.sciencedirect.com/science/article/pii/0268960X9390001K). The genetics of the disease, treatment and coping skills of those affected have been published. Jamaica is a developing country and therefore all resources for the treatment of sickle cell disease is not readily available to all patients. Though overall Jamaican patients with sickle cell disease have an better experience with the disease, they deserve to have access to all treatments (http://onlinelibrary.wiley.com/doi/10.1002/pbc.25563/epdf). Hydroxyurea is a drug that has been significantly beneficial for sickle disease. The drug does not cure but lessens the symptoms of disease. Until recently, the drug was only available to those on the island that could afford it. Currently, there has been an investment by the government to provide Hydroxyurea to all sickle cell patients who would benefit. I would like to see continued commitment by the country to secure funds to support the treatment of sickle cell disease with Hydroxyurea. My fear is that in a country where the US dollar is worth approximately 115 Jamaican dollars, there will be difficulty maintaining this financial support. Also, access to the medication may also be compromised due to the countries financial standing.
Stakeholders include first, the National Health Fund (http://www.nhf.org.jm/) which in 2015, contributed funds to have patients receive medication including Hydroxyurea to treat sickle cell disease (http://www.jamaicaobserver.com/news/Persons-with-sickle-cell-disease-can-now-benefit-from-NHF-_19153890). The fund has significant interest in providing policies to assist with the care of the sickle cell population. Second, Ministry of Health (http://moh.gov.jm/annual-reports/) in 2015, established National health fund with sickle cell disease as a priority for the island. Third, would pharmaceutical companies which produce Hydroxyurea be willing to supply the medication at a lower cost to this developing country? What are benefits and burdens to those companies. Fourth, the University of the West Indies Hospital, which is the home hospital of the Sickle Cell Trust. This is one of the teaching hospitals in Jamaica. Fifth, Kingston Public Hospital (http://www.serha.gov.jm/)hydroxyurea would be made available to patients at this institution as well, however, unsure of their commitment to treating sickle cell disease. Finally, the sickle cell support foundation of Jamaica (www.sicklecellfoundationja.org/) raises awareness about the disease. Funding for patients. Among the founders are at least one with sickle cell disease and they have a positive bias to try and assist others with the disease.
I support making Hydroxyurea available to many of the patients with sickle cell disease. It is not a cure, but is less expensive with lower morbidity and mortality than the cure, bone marrow transplant. In the long run, Hydroxyurea will save the island money that may have been used to care for these patients in the hospital either as outpatients or inpatients. In addition, the medication could improve the experience of those with sickle cell and eventually change the stigma that surrounds the disease in Jamaica. I would primarily appeal to the ministry of health to continue their efforts to support the supply of hydroxyurea to those with sickle cell anemia in the country.