There is a lack of information about genetic and environmental factors that govern the phenotypic diversity of SCD. While robust genetic tools are available, barriers exist in defining phenotypes. Some of these barriers are due to limited clinical and diagnostic facilities to define and measure phenotypes in low-income countries.
Building on existing projects in low-income countries where laboratory and bio informatics facilities are available would extend the network of labs involved. More discussion of a two-tier system for laboratories should be held.