Sickle Cell Disease Treatment Market - Global Industry Analysis, Size, Share, Growth, Trends, and Forecast 2031 - By Product, Technology, Grade, Application, End-user, Region: (North America, Europe, Asia Pacific, Latin America and Middle East and Africa)

Sickle Cell Disease Treatment Market - Global Industry Analysis, Size, Share, Growth, Trends, and Forecast 2031 - By Product, Technology, Grade, Application, End-user, Region: (North America, Europe, Asia Pacific, Latin America and Middle East and Africa)


The global sickle cell disease treatment market encounters numerous challenges that impede its revenue growth. These challenges stem from inadequate healthcare infrastructure, unavailability of drugs in rural regions, lack of reimbursement, high treatment costs, and stringent regulatory approvals. Understanding these factors is crucial for stakeholders looking to navigate and strategize effectively in this complex market.

Lack of Proper Healthcare Infrastructure in MEA

The healthcare sector in the Middle East and Africa (MEA) is experiencing rapid transformation. However, many countries in this region still suffer from inadequate healthcare infrastructure, which hampers the growth of the sickle cell disease treatment market. The underdevelopment and poor implementation of clinical practice guidelines, combined with a shortage of skilled labor in developing nations, further restrict market expansion. These issues create significant barriers to effective treatment and management of sickle cell disease, limiting the market's potential in MEA.

Unavailability of Drugs in Rural Areas

In several tribal regions of India affected by sickle cell disease, the unavailability of essential drugs presents a major challenge. Corruption in drug sales and the low disposable income of most affected individuals exacerbate the problem. These factors create significant obstacles to accessing necessary treatments, thereby hindering market growth in India. Addressing these issues is crucial to improving the reach and effectiveness of sickle cell disease treatments in rural areas.

Lack of Reimbursement in Europe

Despite the serious impact of sickle cell disease, governments and insurance companies in Europe do not provide adequate reimbursement for its treatment. The high costs associated with lifelong treatment often force patients to discontinue their regimens prematurely. This lack of reimbursement is a significant barrier to market growth, as patients struggle to afford the necessary treatments. Implementing better reimbursement policies could enhance market growth and patient outcomes in Europe.

High Cost of Treatment

The high costs associated with treating sickle cell disease remain a major obstacle to market growth. Treatments often require expensive alternative therapies such as blood transfusions and bone marrow transplants. Additionally, the lack of reimbursements exacerbates this issue, making it difficult for patients to afford these treatments. Addressing the high cost of treatment is essential for improving access and fostering market growth.

Lack of FDA Approved Treatment for Sickle Cell Disease

In North America, the U.S. FDA has only approved hydroxyurea and L-glutamine for treating sickle cell anemia. The stringent FDA approval process for sickle cell disease drugs is expected to hinder market growth. The limited availability of FDA-approved treatments restricts the options available to patients and healthcare providers, thus limiting market expansion. Streamlining the approval process and increasing the number of approved treatments could significantly benefit the market.

Sickle Cell Anemia Segment Leads the Global Market

By indication, sickle cell anemia is expected to dominate the global sickle cell disease treatment market, capturing more than half of the revenue share. This segment is projected to be highly valued, reflecting strong demand and potential for growth. Conversely, the Sickle Hemoglobin C disease segment is expected to be the least attractive in terms of market share, with a low market attractiveness index.

In summary, while the global sickle cell disease treatment market has substantial growth potential, several challenges must be addressed to unlock this potential fully. Improving healthcare infrastructure, ensuring drug availability in rural areas, implementing better reimbursement policies, reducing treatment costs, and streamlining regulatory approvals are critical steps toward achieving sustainable growth in this market.

Key Market Player Includes:
• AstraZeneca Plc.
• Eli Lilly and Company
• Bristol-Myers Squibb Company
• Novartis AG
• Pfizer Inc.
• Baxter International Inc.
• Emmaus Life Sciences, Inc.
• Bluebird bio, Inc.
• Global Blood Therapeutics Inc.
• Sangamo Therapeutics, Inc.
• Acceleron Pharma, Inc.
• Arena Pharmaceuticals, Inc.
• Alnylam Pharmaceuticals, Inc.
• Others.

Global Sickle Cell Disease Treatment Market is Segmented as Below:

By Drug Type:
• Hydroxyurea
• Antibiotics
• Pain-relieving Medications
• Others

By Disease Type:
• Sickle cell anemia
• Sickle hemoglobin C disease
• Sickle beta thalassemia
• Others

By Distribution Channel
• Hospital Pharmacies
• Retail Pharmacies
• Online Pharmacies

By Region
• North America
• Latin America
• Europe
• Asia Pacific
• MEA

Please note: Delivery Timelines - 5 working days.


1. Executive Summary
1.1. Global Sickle Cell Disease Treatment Market Snapshot
1.2. Future Projections
1.3. Key Market Trends
1.4. Regional Snapshot, by Value, 2023
1.5. Analyst Recommendations
2. Market Overview
2.1. Market Definitions and Segmentations
2.2. Market Dynamics
2.2.1. Drivers
2.2.2. Restraints
2.2.3. Market Opportunities
2.3. Value Chain Analysis
2.4. Porter’s Five Forces Analysis
2.5. COVID-19 Impact Analysis
2.5.1. Supply
2.5.2. Demand
2.6. PESTLE Analysis
3. Global Sickle Cell Disease Treatment Market Outlook, 2018 – 2031
3.1. Global Sickle Cell Disease Treatment Market Outlook, by Drug Type, Value (US$ Bn), 2018 – 2031
3.1.1. Key Highlights
3.1.1.1. Hydroxyurea
3.1.1.2. Antibiotics
3.1.1.3. Pain-relieving Medications
3.1.1.4. Others
3.2. Global Sickle Cell Disease Treatment Market Outlook, by Disease Type, Value (US$ Bn), 2018 – 2031
3.2.1. Key Highlights
3.2.1.1. Sickle cell anaemia
3.2.1.2. Sickle haemoglobin C disease
3.2.1.3. Sickle beta thalassemia
3.2.1.4. Others
3.3. Global Sickle Cell Disease Treatment Market Outlook, by End User, Value (US$ Bn), 2018 – 2031
3.3.1. Key Highlights
3.3.1.1. Hospital Pharmacies
3.3.1.2. Retail Pharmacies
3.3.1.3. Online Pharmacies
3.4. Global Sickle Cell Disease Treatment Market Outlook, by Region, Value (US$ Bn), 2018 – 2031
3.4.1. Key Highlights
3.4.1.1. North America
3.4.1.2. Europe
3.4.1.3. Asia Pacific
3.4.1.4. Latin America
3.4.1.5. Middle East & Africa
4. North America Sickle Cell Disease Treatment Market Outlook, 2018 – 2031
4.1. North America Sickle Cell Disease Treatment Market Outlook, by Drug Type, Value (US$ Bn), 2018 – 2031
4.1.1. Key Highlights
4.1.1.1. Hydroxyurea
4.1.1.2. Antibiotics
4.1.1.3. Pain-relieving Medications
4.1.1.4. Others
4.2. North America Sickle Cell Disease Treatment Market Outlook, by Disease Type, Value (US$ Bn), 2018 – 2031
4.2.1. Key Highlights
4.2.1.1. Sickle cell anaemia
4.2.1.2. Sickle haemoglobin C disease
4.2.1.3. Sickle beta thalassemia
4.2.1.4. Others
4.3. North America Sickle Cell Disease Treatment Market Outlook, by End User, Value (US$ Bn), 2018 – 2031
4.3.1. Key Highlights
4.3.1.1. Hospital Pharmacies
4.3.1.2. Retail Pharmacies
4.3.1.3. Online Pharmacies
4.3.2. BPS Analysis/Market Attractiveness Analysis
4.4. North America Sickle Cell Disease Treatment Market Outlook, by Country, Value (US$ Bn), 2018 – 2031
4.4.1. Key Highlights
4.4.1.1. U.S. Sickle Cell Disease Treatment Market by Drug Type, Value (US$ Bn), 2018 – 2031
4.4.1.2. U.S. Sickle Cell Disease Treatment Market by Disease Type, Value (US$ Bn), 2018 – 2031
4.4.1.3. U.S. Sickle Cell Disease Treatment Market by End User, Value (US$ Bn), 2018 – 2031
4.4.1.4. Canada Sickle Cell Disease Treatment Market by Drug Type, Value (US$ Bn), 2018 – 2031
4.4.1.5. Canada Sickle Cell Disease Treatment Market by Disease Type, Value (US$ Bn), 2018 – 2031
4.4.1.6. Canada Sickle Cell Disease Treatment Market by End User, Value (US$ Bn), 2018 – 2031
4.4.2. BPS Analysis/Market Attractiveness Analysis
5. Europe Sickle Cell Disease Treatment Market Outlook, 2018 – 2031
5.1. Europe Sickle Cell Disease Treatment Market Outlook, by Drug Type, Value (US$ Bn), 2018 – 2031
5.1.1. Key Highlights
5.1.1.1. Hydroxyurea
5.1.1.2. Antibiotics
5.1.1.3. Pain-relieving Medications
5.1.1.4. Others
5.2. Europe Sickle Cell Disease Treatment Market Outlook, by Disease Type, Value (US$ Bn), 2018 – 2031
5.2.1. Key Highlights
5.2.1.1. Sickle cell anaemia
5.2.1.2. Sickle haemoglobin C disease
5.2.1.3. Sickle beta thalassemia
5.2.1.4. Others
5.3. Europe Sickle Cell Disease Treatment Market Outlook, by End User, Value (US$ Bn), 2018 – 2031
5.3.1. Key Highlights
5.3.1.1. Hospital Pharmacies
5.3.1.2. Retail Pharmacies
5.3.1.3. Online Pharmacies
5.3.2. BPS Analysis/Market Attractiveness Analysis
5.4. Europe Sickle Cell Disease Treatment Market Outlook, by Country, Value (US$ Bn), 2018 – 2031
5.4.1. Key Highlights
5.4.1.1. Germany Sickle Cell Disease Treatment Market by Drug Type, Value (US$ Bn), 2018 – 2031
5.4.1.2. Germany Sickle Cell Disease Treatment Market by Disease Type, Value (US$ Bn), 2018 – 2031
5.4.1.3. Germany Sickle Cell Disease Treatment Market by End User, Value (US$ Bn), 2018 – 2031
5.4.1.4. U.K. Sickle Cell Disease Treatment Market by Drug Type, Value (US$ Bn), 2018 – 2031
5.4.1.5. U.K. Sickle Cell Disease Treatment Market by Disease Type, Value (US$ Bn), 2018 – 2031
5.4.1.6. U.K. Sickle Cell Disease Treatment Market by End User, Value (US$ Bn), 2018 – 2031
5.4.1.7. France Sickle Cell Disease Treatment Market by Drug Type, Value (US$ Bn), 2018 – 2031
5.4.1.8. France Sickle Cell Disease Treatment Market by Disease Type, Value (US$ Bn), 2018 – 2031
5.4.1.9. France Sickle Cell Disease Treatment Market by End User, Value (US$ Bn), 2018 – 2031
5.4.1.10. Italy Sickle Cell Disease Treatment Market by Drug Type, Value (US$ Bn), 2018 – 2031
5.4.1.11. Italy Sickle Cell Disease Treatment Market by Disease Type, Value (US$ Bn), 2018 – 2031
5.4.1.12. Italy Sickle Cell Disease Treatment Market by End User, Value (US$ Bn), 2018 – 2031
5.4.1.13. Turkey Sickle Cell Disease Treatment Market by Drug Type, Value (US$ Bn), 2018 – 2031
5.4.1.14. Turkey Sickle Cell Disease Treatment Market by Disease Type, Value (US$ Bn), 2018 – 2031
5.4.1.15. Turkey Sickle Cell Disease Treatment Market by End User, Value (US$ Bn), 2018 – 2031
5.4.1.16. Russia Sickle Cell Disease Treatment Market by Drug Type, Value (US$ Bn), 2018 – 2031
5.4.1.17. Russia Sickle Cell Disease Treatment Market by Disease Type, Value (US$ Bn), 2018 – 2031
5.4.1.18. Russia Sickle Cell Disease Treatment Market by End User, Value (US$ Bn), 2018 – 2031
5.4.1.19. Rest of Europe Sickle Cell Disease Treatment Market by Drug Type, Value (US$ Bn), 2018 – 2031
5.4.1.20. Rest of Europe Sickle Cell Disease Treatment Market by Disease Type, Value (US$ Bn), 2018 – 2031
5.4.1.21. Rest of Europe Sickle Cell Disease Treatment Market by End User, Value (US$ Bn), 2018 – 2031
5.4.2. BPS Analysis/Market Attractiveness Analysis
6. Asia Pacific Sickle Cell Disease Treatment Market Outlook, 2018 – 2031
6.1. Asia Pacific Sickle Cell Disease Treatment Market Outlook, by Drug Type, Value (US$ Bn), 2018 – 2031
6.1.1. Key Highlights
6.1.1.1. Hydroxyurea
6.1.1.2. Antibiotics
6.1.1.3. Pain-relieving Medications
6.1.1.4. Others
6.2. Asia Pacific Sickle Cell Disease Treatment Market Outlook, by Disease Type, Value (US$ Bn), 2018 – 2031
6.2.1. Key Highlights
6.2.1.1. Sickle cell anaemia
6.2.1.2. Sickle haemoglobin C disease
6.2.1.3. Sickle beta thalassemia
6.2.1.4. Others
6.3. Asia Pacific Sickle Cell Disease Treatment Market Outlook, by End User, Value (US$ Bn), 2018 – 2031
6.3.1. Key Highlights
6.3.1.1. Hospital Pharmacies
6.3.1.2. Retail Pharmacies
6.3.1.3. Online Pharmacies
6.3.2. BPS Analysis/Market Attractiveness Analysis
6.4. Asia Pacific Sickle Cell Disease Treatment Market Outlook, by Country, Value (US$ Bn), 2018 – 2031
6.4.1. Key Highlights
6.4.1.1. China Sickle Cell Disease Treatment Market by Drug Type, Value (US$ Bn), 2018 – 2031
6.4.1.2. China Sickle Cell Disease Treatment Market by Disease Type, Value (US$ Bn), 2018 – 2031
6.4.1.3. China Sickle Cell Disease Treatment Market by End User, Value (US$ Bn), 2018 – 2031
6.4.1.4. Japan Sickle Cell Disease Treatment Market by Drug Type, Value (US$ Bn), 2018 – 2031
6.4.1.5. Japan Sickle Cell Disease Treatment Market by Disease Type, Value (US$ Bn), 2018 – 2031
6.4.1.6. Japan Sickle Cell Disease Treatment Market by End User, Value (US$ Bn), 2018 – 2031
6.4.1.7. South Korea Sickle Cell Disease Treatment Market by Drug Type, Value (US$ Bn), 2018 – 2031
6.4.1.8. South Korea Sickle Cell Disease Treatment Market by Disease Type, Value (US$ Bn), 2018 – 2031
6.4.1.9. South Korea Sickle Cell Disease Treatment Market by End User, Value (US$ Bn), 2018 – 2031
6.4.1.10. India Sickle Cell Disease Treatment Market by Drug Type, Value (US$ Bn), 2018 – 2031
6.4.1.11. India Sickle Cell Disease Treatment Market by Disease Type, Value (US$ Bn), 2018 – 2031
6.4.1.12. India Sickle Cell Disease Treatment Market by End User, Value (US$ Bn), 2018 – 2031
6.4.1.13. Southeast Asia Sickle Cell Disease Treatment Market by Drug Type, Value (US$ Bn), 2018 – 2031
6.4.1.14. Southeast Asia Sickle Cell Disease Treatment Market by Disease Type, Value (US$ Bn), 2018 – 2031
6.4.1.15. Southeast Asia Sickle Cell Disease Treatment Market by End User, Value (US$ Bn), 2018 – 2031
6.4.1.16. Rest of Asia Pacific Sickle Cell Disease Treatment Market by Drug Type, Value (US$ Bn), 2018 – 2031
6.4.1.17. Rest of Asia Pacific Sickle Cell Disease Treatment Market by Disease Type, Value (US$ Bn), 2018 – 2031
6.4.1.18. Rest of Asia Pacific Sickle Cell Disease Treatment Market by End User, Value (US$ Bn), 2018 – 2031
6.4.2. BPS Analysis/Market Attractiveness Analysis
7. Latin America Sickle Cell Disease Treatment Market Outlook, 2018 – 2031
7.1. Latin America Sickle Cell Disease Treatment Market Outlook, by Drug Type, Value (US$ Bn), 2018 – 2031
7.1.1. Key Highlights
7.1.1.1. Hydroxyurea
7.1.1.2. Antibiotics
7.1.1.3. Pain-relieving Medications
7.1.1.4. Others
7.2. Latin America Sickle Cell Disease Treatment Market Outlook, by Disease Type, Value (US$ Bn), 2018 – 2031
7.2.1.1. Sickle cell anaemia
7.2.1.2. Sickle haemoglobin C disease
7.2.1.3. Sickle beta thalassemia
7.2.1.4. Others
7.3. Latin America Sickle Cell Disease Treatment Market Outlook, by End User, Value (US$ Bn), 2018 – 2031
7.3.1. Key Highlights
7.3.1.1. Hospital Pharmacies
7.3.1.2. Retail Pharmacies
7.3.1.3. Online Pharmacies
7.3.2. BPS Analysis/Market Attractiveness Analysis
7.4. Latin America Sickle Cell Disease Treatment Market Outlook, by Country, Value (US$ Bn), 2018 – 2031
7.4.1. Key Highlights
7.4.1.1. Brazil Sickle Cell Disease Treatment Market by Drug Type, Value (US$ Bn), 2018 – 2031
7.4.1.2. Brazil Sickle Cell Disease Treatment Market by Disease Type, Value (US$ Bn), 2018 – 2031
7.4.1.3. Brazil Sickle Cell Disease Treatment Market by End User, Value (US$ Bn), 2018 – 2031
7.4.1.4. Mexico Sickle Cell Disease Treatment Market by Drug Type, Value (US$ Bn), 2018 – 2031
7.4.1.5. Mexico Sickle Cell Disease Treatment Market by Disease Type, Value (US$ Bn), 2018 – 2031
7.4.1.6. Mexico Sickle Cell Disease Treatment Market by End User, Value (US$ Bn), 2018 – 2031
7.4.1.7. Argentina Sickle Cell Disease Treatment Market by Drug Type, Value (US$ Bn), 2018 – 2031
7.4.1.8. Argentina Sickle Cell Disease Treatment Market by Disease Type, Value (US$ Bn), 2018 – 2031
7.4.1.9. Argentina Sickle Cell Disease Treatment Market by End User, Value (US$ Bn), 2018 – 2031
7.4.1.10. Rest of Latin America Sickle Cell Disease Treatment Market by Drug Type, Value (US$ Bn), 2018 – 2031
7.4.1.11. Rest of Latin America Sickle Cell Disease Treatment Market by Disease Type, Value (US$ Bn), 2018 – 2031
7.4.1.12. Rest of Latin America Sickle Cell Disease Treatment Market by End User, Value (US$ Bn), 2018 – 2031
7.4.2. BPS Analysis/Market Attractiveness Analysis
8. Middle East & Africa Sickle Cell Disease Treatment Market Outlook, 2018 – 2031
8.1. Middle East & Africa Sickle Cell Disease Treatment Market Outlook, by Drug Type, Value (US$ Bn), 2018 – 2031
8.1.1. Key Highlights
8.1.1.1. Hydroxyurea
8.1.1.2. Antibiotics
8.1.1.3. Pain-relieving Medications
8.1.1.4. Others
8.2. Middle East & Africa Sickle Cell Disease Treatment Market Outlook, by Disease Type, Value (US$ Bn), 2018 – 2031
8.2.1. Key Highlights
8.2.1.1. Sickle cell anaemia
8.2.1.2. Sickle haemoglobin C disease
8.2.1.3. Sickle beta thalassemia
8.2.1.4. Others
8.3. Middle East & Africa Sickle Cell Disease Treatment Market Outlook, by End User, Value (US$ Bn), 2018 – 2031
8.3.1. Key Highlights
8.3.1.1. Hospital Pharmacies
8.3.1.2. Retail Pharmacies
8.3.1.3. Online Pharmacies
8.3.2. BPS Analysis/Market Attractiveness Analysis
8.4. Middle East & Africa Sickle Cell Disease Treatment Market Outlook, by Country, Value (US$ Bn), 2018 – 2031
8.4.1. Key Highlights
8.4.1.1. GCC Sickle Cell Disease Treatment Market by Drug Type, Value (US$ Bn), 2018 – 2031
8.4.1.2. GCC Sickle Cell Disease Treatment Market by Disease Type, Value (US$ Bn), 2018 – 2031
8.4.1.3. GCC Sickle Cell Disease Treatment Market by End User, Value (US$ Bn), 2018 – 2031
8.4.1.4. South Africa Sickle Cell Disease Treatment Market by Drug Type, Value (US$ Bn), 2018 – 2031
8.4.1.5. South Africa Sickle Cell Disease Treatment Market by Disease Type, Value (US$ Bn), 2018 – 2031
8.4.1.6. South Africa Sickle Cell Disease Treatment Market by End User, Value (US$ Bn), 2018 – 2031
8.4.1.7. Egypt Sickle Cell Disease Treatment Market by Drug Type, Value (US$ Bn), 2018 – 2031
8.4.1.8. Egypt Sickle Cell Disease Treatment Market by Disease Type, Value (US$ Bn), 2018 – 2031
8.4.1.9. Egypt Sickle Cell Disease Treatment Market by End User, Value (US$ Bn), 2018 – 2031
8.4.1.10. Nigeria Sickle Cell Disease Treatment Market by Drug Type, Value (US$ Bn), 2018 – 2031
8.4.1.11. Nigeria Sickle Cell Disease Treatment Market by Disease Type, Value (US$ Bn), 2018 – 2031
8.4.1.12. Nigeria Sickle Cell Disease Treatment Market by End User, Value (US$ Bn), 2018 – 2031
8.4.1.13. Rest of Middle East & Africa Sickle Cell Disease Treatment Market by Drug Type, Value (US$ Bn), 2018 – 2031
8.4.1.14. Rest of Middle East & Africa Sickle Cell Disease Treatment Market by Disease Type, Value (US$ Bn), 2018 – 2031
8.4.1.15. Rest of Middle East & Africa Sickle Cell Disease Treatment Market by End User, Value (US$ Bn), 2018 – 2031
8.4.2. BPS Analysis/Market Attractiveness Analysis
9. Competitive Landscape
9.1. Product vs Indication Heatmap
9.2. Company Market Share Analysis, 2022
9.3. Competitive Dashboard
9.4. Company Profiles
9.4.1. AstraZeneca Plc.
9.4.1.1. Company Overview
9.4.1.2. Product Portfolio
9.4.1.3. Financial Overview
9.4.1.4. Business Strategies and Development
9.4.2. Eli Lilly and Company
9.4.2.1. Company Overview
9.4.2.2. Product Portfolio
9.4.2.3. Financial Overview
9.4.2.4. Business Strategies and Development
9.4.3. Bristol-Myers Squibb Company
9.4.3.1. Company Overview
9.4.3.2. Product Portfolio
9.4.3.3. Financial Overview
9.4.3.4. Business Strategies and Development
9.4.4. Novartis AG
9.4.4.1. Company Overview
9.4.4.2. Product Portfolio
9.4.4.3. Financial Overview
9.4.4.4. Business Strategies and Development
9.4.5. Pfizer Inc.
9.4.5.1. Company Overview
9.4.5.2. Product Portfolio
9.4.5.3. Financial Overview
9.4.5.4. Business Strategies and Development
9.4.6. Baxter International Inc.
9.4.6.1. Company Overview
9.4.6.2. Product Portfolio
9.4.6.3. Financial Overview
9.4.6.4. Business Strategies and Development
9.4.7. Emmaus Life Sciences, Inc.
9.4.7.1. Company Overview
9.4.7.2. Product Portfolio
9.4.7.3. Financial Overview
9.4.7.4. Business Strategies and Development
9.4.8. Bluebird bio, Inc.
9.4.8.1. Company Overview
9.4.8.2. Product Portfolio
9.4.8.3. Financial Overview
9.4.8.4. Business Strategies and Development
9.4.9. Others
9.4.9.1. Company Overview
9.4.9.2. Product Portfolio
9.4.9.3. Financial Overview
9.4.9.4. Business Strategies and Development
10. Appendix
10.1. Research Methodology
10.2. Report Assumptions 10.3.Acronyms and Abbreviations
List of Region/Countries
North America
U.S.
Canada
Europe
Germany
U.K.
France
Italy
Turkey
Russia
Rest of Europe
Asia Pacific
China
Japan
South Korea
India
Southeast Asia
Rest of Asia Pacific
Latin America
Brazil
Mexico
Rest of Latin America
Middle East & Africa
GCC
South Africa
Rest of Middle East & Africa

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