Thalassemia

• Thalassemia is an inherited blood disorder characterised by less oxygen-carrying protein (haemoglobin) and fewer red blood cells in the body than normal. 
• Symptoms include fatigue, weakness, paleness and slow growth. Mild forms may not need treatment. Severe forms may require blood transfusions or a donor stem-cell transplant.
• The best therapeutic option for Thalassemia major patients is bone marrow transplant from an HLA-identical( When two people share the same HumanLeukocyte Antigens) donor.

Why in News?

• A one-year-old sibling has saved her brother’s life who was born with Thalassemia by donating her bone marrow (saviour sibling). This was India’s first ‘saviour sibling’ experiment.
• Saviour siblings are children who are born to provide HLA compatible body parts, typically umbilical cord blood to be used for bone marrow transplantation, in order to save the life of their older sibling. The savior sibling is conceived through in vitro fertilization. 

Bone Marrow

• Bone marrow is a semi-solid tissue found within the spongy or cancellous portions of bones
• Bone marrow transplants can be conducted to treat severe diseases of the bone marrow, including certain forms of cancer such as leukemia

Additional Details

India and Thalassemia

• There are around 270 million Thalassemia patients in the world. India has the largest number of children with Thalassemia major in the world, about 1 to 1.5 lakhs, and about 10,000 -15,000 children having Thalassemia major are born every year. 
• The only cure available for such children is bone marrow transplantation (BMT).
• Recently, the Ministry of Health and Family Welfare launched the second phase of “Thalassemia Bal Sewa Yojna” for the underprivileged Thalassemic patients

IVF

• In vitro fertilisation is a process of fertilisation where an egg is combined with sperm outside the body, in vitro. The process involves monitoring and stimulating a woman’s ovulatory process, removing an ovum or ova from the woman’s ovaries and letting sperm fertilise them in a liquid in a laboratory.

Surrogacy

• Surrogacy is the process of a woman carrying a child in her uterus on behalf of another person or couple. Surrogate Mothers are of two types
  • Traditional surrogate–  It’s a woman who gets artificially inseminated with the father’s sperm. She then carries the baby and delivers it for you and your partner to raise. A traditional surrogate is the baby’s biological mother. That’s because it was her egg that was fertilized by the father’s sperm. Donor sperm can also be used.
  • Gestational surrogates– A technique called “in vitro fertilization” (IVF) now makes it possible to gather eggs from the mother, fertilize them with sperm from the father, and place the embryo into the uterus of a gestational surrogate. The surrogate then carries the baby until birth. She doesn’t have any genetic ties to the child because it wasn’t her egg that was used. A gestational surrogate is called the “birth mother.” The biological mother, though, is still the woman whose egg was fertilized.

India and Surrogacy

• The Surrogacy (Regulation) Bill, 2020 – The Bill prohibits commercial surrogacy, but allows altruistic surrogacy.
• Provides for the constitution of surrogacy boards at the national as well as state levels to ensure effective regulation.
• Altruistic surrogacy involves no monetary compensation to the surrogate mother other than the medical expenses and insurance coverage during the pregnancy.  Commercial surrogacy includes surrogacy or its related procedures undertaken for a monetary benefit or reward (in cash or kind) exceeding the basic medical expenses and insurance coverage.
• Surrogacy is permitted when it is: (i) for intending couples who suffer from proven infertility; (ii) altruistic; (iii) not for commercial purposes; (iv) not for producing children for sale, prostitution or other forms of exploitation; and (v) for any condition or disease specified through regulations.
• The Rajya Sabha Select Committee to the Surrogacy (Regulation) Bill, 2019, in its report has recommended that the definition of a surrogate mother should be expanded to include any willing woman and not just restricted to close relatives alone. Letting a single woman (including divorcee, widows or a Persons of the Indian Origin) avail surrogacy, removing the provision of requirement of five years as period of inability to conceive before opting for surrogacy are some of the other major changes as recommended by the panel.
• Citing the malpractice of “renting the womb”, the government of India banned the surrogacy for foreign nationals in 2015. The criticism was that surrogacy leads to commoditization of the child, it breaks the bond between the mother and the child, it interferes with nature, and it leads to the exploitation of poor women in underdeveloped countries who sell their bodies for money

Reference:

1. https://www.thehindu.com/sci-tech/health/a-sister-born-to-save-ailing-brother/article32856312.ece