Sickle cell disease medical history in Brazil and global politics

Juliana M. Cavalcanti, PhD, University of São Paulo, Brazil

The first medical descriptions of sickle cell disease (SCD) in Brazil occurred in 1930s, followed by a decade of extensive screening of many different populations groups. Thousands of soldiers, indigenous people and industrial workers were submitted to blood screening for sickle cells. Domestic migration grew exponentially in 1940s and fears of ‘dissemination’ (sic) of sickle cell gene brought by migrant workers of Northeast appeared in some medical works. Nonetheless beliefs of a ‘dilution’ of the gene through racial mixture achieved a strong and wider significance for a society concerned with population whiteness. In the post-war era, new diagnostic tools, inheritance theories and, in particular, discussions on the concepts of race and racial relations, both nationally and internationally, were changing previous racialist and racist views. Nonetheless, the Brazilian medical interpretations of sickle cell disease continued to racialize it and even use deep-rooted racist formulations to explain its symptoms or the existence of the disease. Between 2006 and 2010 Brazilian government promoted a series of scientific encounters and visits mediated by diplomatic and health ministries in some African countries to discuss models of care to SCD. The objective was to change or shake the ample interpretation called “Education for Prevention”, i. e., the effort to create policies based on preconception screening, genetic counseling and abortions. Sickle cell disease has become a global issue and prevention has been the health strategy chosen as a solution. In this presentation I seek to debate how past notions about disease, race and black bodies still shape, under new guises, the definition of SCD in the contemporary discourse.