Hydroxyurea is an effective treatment for sickle cell anemia (SCA); however, the majority of studies investigating this agent have been conducted in the US and Europe, not in sub-Saharan Afria, which has the greatest burden of SCA. Here, Leon Tshilolo, MD, PhD, of Centre Hospitalier Monkole, Kinshasa, DR Congo, presents the Realizing Effectiveness Across Continents with Hydroxyurea (REACH; NCT01966731) study, a prospective, multi-national study of hydroxyurea for children with SCA in sub-Saharan Africa. These results demonstrated a wide array of benefits for daily oral hydroxyurea; with these results better access to hydroxyurea in Africa can be planned. This video was recorded at the American Society of Hematology (ASH) 2018 Annual Meeting and Exposition in San Diego, CA.