Editorial: Innovations and challenges in sickle cell disease: bridging gaps in global health

Editorial on the Research Topic
Innovations and challenges in sickle cell disease: bridging gaps in global health

Sickle cell disease (SCD) stands as one of the clearest successes of modern medicine. Its molecular basis is known. Its clinical course is defined. Effective interventions exist. And yet, despite this, millions of people live with delayed diagnosis, fragmented care, and preventable suffering. This gap does not arise from lack of knowledge. It reflects how health systems translate science into care and how societies assign value to certain conditions and populations.

This Research Topic, Innovations and Challenges in Sickle Cell Disease: Bridging Gaps in Global Health, was developed to examine that gap. Its aim was not to catalogue novelty but to explore how innovation interacts with health systems, social structures, and ethical responsibility. The six contributions form a unified body of work that places SCD within the broader landscape of global health equity.

A first axis across the Topic addresses access to care as a structural issue. The study by Onavbavba et al., “Improving access to healthcare services for sickle cell disease patients in Nigeria: perspectives and views of healthcare professionals”, examines how clinicians navigate workforce shortages, limited infrastructure, and fragmented referral systems. The findings show that barriers to care arise from system design rather than professional neglect. Innovation, in this context, requires reorganization of services and sustained investment in care pathways.

A second axis focuses on early diagnosis and the ethical meaning of screening. Aliyu et al., in “Awareness, acceptability and factors associated with newborn screening for sickle cell disease among pregnant women in a Northern Nigerian Tertiary Hospital”, explore how perception, trust, and health literacy shape screening uptake. The study shows that early diagnosis carries an ethical obligation. Detection without access to follow-up care weakens the moral foundation of screening programs.

A third strand centers on psychological suffering and mental health care. Patena et al., in “Barriers and facilitators to implementing a task-sharing mental health intervention for sickle cell disease populations in low- and middle-income countries”, examine how psychosocial support can be integrated into routine care through task-sharing models. This work treats mental health as a core element of SCD care. It challenges care models that prioritize survival while neglecting lived experience.

The Topic also addresses system vulnerability during global crises. Martí-Carvajal and De Sanctis, in “A perfect storm: the deadly intersection of sickle cell disease and COVID-19”, analyze how pandemics expose structural weakness in chronic disease care. SCD emerges as a sentinel condition that reveals how health systems protect or abandon vulnerable groups during periods of strain.

Li et al., in “Soluble immune checkpoint landscape in sickle cell disease links systemic inflammation, autoimmunity, and pain”, contribute a mechanistic perspective that connects immune regulation with pain and inflammation. This work links biological insight with clinical relevance and reinforces the need to integrate basic science with patient-centered outcomes.

Finally, “Cochrane’s contribution to global health: three decades of progress in sickle cell disease research” examines the role of evidence synthesis in shaping practice. The article highlights progress while exposing persistent gaps in high-quality trials and implementation research. Evidence synthesis appears here as both a scientific and ethical act, guiding decisions that affect populations with limited research visibility (Marti—Carvajal).

Across these contributions, a shared conclusion emerges. The central challenge in SCD does not lie in discovery. It lies in translation. Knowledge exists. Tools exist. What varies is the capacity and resolve to deliver care with consistency and equity. This gap reflects choices embedded in health policy, funding priorities, and system design.

Methodological diversity strengthens this Research Topic. Quantitative surveys, qualitative analyses, mechanistic studies, and integrative reviews coexist within a single framework. This plurality reflects the nature of SCD itself. No single discipline can address a condition shaped by biology, systems, culture, and ethics.

The ethical dimension runs through all six articles. Early diagnosis demands continuity of care. Mental health support affirms the value of psychological well-being. Crisis preparedness reflects a duty to protect those at greatest risk. Evidence synthesis shapes whose needs receive attention. In SCD, ethics does not sit outside science. It defines the meaning of progress.

Several priorities follow from this work. Screening programs must link detection with care. Health systems must treat service organization as a form of innovation. Psychosocial care must stand alongside biomedical treatment. Research agendas must address gaps that persist in settings with limited resources.

This Research Topic frames SCD as more than a genetic disorder. It presents SCD as a measure of global health integrity. Progress depends not only on what medicine can do but on what health systems choose to deliver.

Sickle cell disease remains a moral benchmark for global health, testing whether scientific knowledge can be paired with the commitment to ensure care, dignity, and justice for all who live with disease.

Author contributions

AM-C: Writing – original draft, Writing – review & editing, Conceptualization.

Acknowledgments

I thank the co-editors for their initial support in shaping the scope of this Research Topic. I also acknowledge the handling editors and the Editorial Office at Frontiers in Hematology for their guidance throughout the editorial process. Finally, I express my gratitude to the peer reviewers whose careful evaluations strengthened the quality and integrity of the published work.

Conflict of interest

The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

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