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.
Thalassaemia syndromes are inherited haemoglobin disorders caused by mutations affecting α- and β-globin chains, ranging in severity from asymptomatic to transfusion-dependent. This Series paper synthesises epidemiological data across ten WHO Southeast Asia Region (SEAR) countries, combining local expertise with a rapid literature review. Due to the high prevalence of α- and β-thalassaemia variants, as well as haemoglobin E, the SEAR carries a disproportionately high burden and faces specific challenges. Although a small number of mutations tends to dominate in each country, the range of underlying mutations and deletions is complex. Beyond molecular studies, epidemiological data remain limited in most SEAR countries. Key challenges include blood supply shortages, consanguinity, gender-based disparities in healthcare access, population migration redistributing mutation profiles, and poor awareness. Recommendations to reduce the health burden of thalassaemia syndromes in the SEAR include setting up national registries, expanding premarital and prenatal screening, improving blood supply coordination, and promoting culturally sensitive education. Without targeted investments and policy commitment, most SEAR populations will remain unable to benefit from recent therapeutic advances, including emerging gene therapies.
