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Genetic diseases and disabilities have been described as the most ubiquitous and burdensome to the populations. The hereditary anemia especially due to sickle cell is common globally with variably high prevalence in indigenous populations. In India, several endogamous tribal pockets that have been ma-laria endemic harbor sickle cell gene in strikingly high frequency. In this back-ground management of sickle cell patients in context of contemporary health care system remains limited and requires integration of appropriate strategies into the existing health care delivery system. This may involve research, di-agnosis, training, genetic counseling and possible remedial interventions for urban as well as rural populations. Remedial interventions that are possible in existing health care delivery system and potential therapies under investigation have been discussed