“Coalition Calls for Mandatory Genotype Testing Before Marriage to Reduce Sickle Cell Disease in Nigeria”

“Coalition Calls for Mandatory Genotype Testing Before Marriage to Reduce Sickle Cell Disease in Nigeria”

A coalition of health advocates has called for compulsory genotype testing for intending couples in Nigeria, arguing that earlier and better informed reproductive decisions could help reduce the number of children born with sickle cell disease.

The campaign renews a long running public-health debate around premarital screening in Nigeria, where sickle cell disease remains a major health burden. Advocates say genotype testing should be made widely accessible and integrated into marriage preparation processes, alongside confidential genetic counselling and stronger public education.

Sickle cell disease is an inherited blood disorder that can occur when both parents carry the sickle cell trait. When two people with the AS genotype have a child, each pregnancy carries a 25 per cent chance of producing a child with sickle cell disease, a 50 per cent chance of producing a child who carries the trait, and a 25 per cent chance of producing a child without the trait.

The coalition’s position is that knowing one’s genotype before marriage can allow couples to make informed decisions earlier, rather than discovering potential genetic incompatibility after emotional, family and financial commitments have deepened.

A Renewed Push for Prevention

Nigeria has one of the world’s highest burdens of sickle cell disease. Public health researchers have repeatedly identified premarital genotype screening, genetic counselling, newborn screening and improved access to treatment as important components of a broader response to the condition.

In 2025, Jigawa State announced compulsory genotype testing for intending couples as part of efforts to reduce sickle cell disease cases, highlighting the growing interest among state authorities in prevention focused policies.

The latest advocacy call, however, raises questions about how a mandatory national policy would be implemented, funded and monitored across Nigeria’s diverse religious, cultural and legal settings.

Health experts have stressed that screening should not be treated as a tool for discrimination against people living with sickle cell disease or those who carry the sickle cell trait. Rather, they argue that it should be paired with accurate counselling, voluntary and confidential medical support, and respect for the reproductive rights of couples.

Screening Must Be Matched With Counselling

Research on premarital screening in Nigeria has found that awareness of genotype testing does not always translate into strong understanding of sickle cell disease or informed decision-making.

A study involving final-year undergraduates in south west Nigeria found that while many respondents had positive attitudes towards premarital genotype screening, only a small proportion demonstrated good knowledge of sickle cell disease.

Another review of premarital sickle cell trait screening across Africa found that uptake remains uneven, with awareness and access playing a significant role in whether people seek testing before marriage.

These findings reinforce the argument that genotype testing alone may not be sufficient. Public health advocates say couples need access to trained genetic counsellors who can explain test results, inheritance risks and available family planning options without coercion or stigma.

Balancing Public Health and Personal Choice

The proposal for mandatory testing has generated debate because marriage is both a personal and social institution in Nigeria. Supporters say the policy could help prevent avoidable suffering and reduce the long-term cost of managing sickle cell disease for families and the health system.

Critics, however, may question whether compulsory testing could lead to discrimination, social pressure or denial of marriage rights for people whose genotypes are considered incompatible. Previous research has documented concerns around religious institutions discouraging or refusing to conduct weddings for couples who are both sickle cell trait carriers.

A rights-sensitive approach, health specialists say, would focus on early testing ideally during adolescence or early adulthood so that young people understand their genotype long before marriage plans begin. It would also require reliable laboratory services, affordable testing, protection of medical privacy and sustained public education.

The Wider Sickle Cell Response

The renewed call comes as Nigeria continues to confront the broader challenges of sickle cell disease, including delayed diagnosis, limited specialist care, high treatment costs and stigma faced by people living with the condition.

Premarital genotype screening is widely viewed as one preventive measure, but experts emphasise that it should complement not replace investment in newborn screening, comprehensive clinical care, access to essential medicines and support for families affected by sickle cell disease.

For the coalition, the central message is clear: Nigerians should know their genotype early, receive accurate counselling and be equipped to make informed decisions about marriage and family planning.