HIV charities express ‘shock and disbelief’ over NHS decision not to distribute PrEP
By Will Stroude
HIV charities have expressed their “shock and disbelief” at NHS England’s announcement that HIV-preventing PrEP medication will not be made widely available on the NHS.
Following an 18-month consideration period, NHS England published a statement on its website yesterday (March 21) in which it confirmed that it will not fund wide-scale roll-out of the drugs, despite the findings of the UK’s recent PROUD study, which found that taking the drug Truvada daily proved “highly effective” in reducing the spread of HIV.
Truvada was approved for use in the USA in 2012, and PrEP medication has since been approved in France, Canada, Israel, and Kenya.
Outlining the reasons for its decision, NHS England said that “local authorities are the responsible commissioner for HIV prevention services” – though it’s worth noting that the NHS is responsible for other sexual health provisions such as the oral contraceptive pill.
Instead of a widespread roll-out, the body said it woyuld be making £2million available over the next two years to run a number of PrEP “test sites” aimed at providing protection for just 500 men deemed most at risk.
Deborah Gold, Chief executive of National AIDS Trust, said of the news: “NAT shares the anger and distress felt by many thousands of people across the country at NHS England’s decision to abandon its work to provide PrEP, near the very end of the process. In a shocking U-turn, NHS England has pulled the plug on over 18 months of hard work which demonstrated the need, efficacy and cost-effectiveness of PrEP.
“Instead of a long-term policy to give PrEP to all who need it, there will be £2 million over two years for 500 gay men ‘most at risk’. The decision is not informed by any due process; the amount of money is arbitrary; the claim that more ‘testing’ of PrEP is needed is disingenuous. 500 does not remotely cover the number of gay men at high risk of HIV nor meet the needs of heterosexuals at risk. There is no clarity within the Department of Health, the NHS or Public Health England as to who long-term is responsible to commission and fund PrEP.
“This is simple maladministration with serious consequences. Over 5,000 gay men will get HIV over the next two years – very many of whom would not have done so if PrEP had been delivered as proposed.
“The US, Canada, France, Israel, Kenya have all made PrEP available. Faced with one of the most exciting prevention options to emerge since the HIV epidemic began, and which offers the prospect of real success in combatting this virus, the NHS has failed miserably to deliver.
“We call on Ministers to intervene and reverse this deplorable decision – securing a process to provide PrEP on the basis of evidence and need.”
Ian Green, Terrence Higgins trust CEO, used similarly strong language to condemn the “shameful” decision.
“By denying full availability of PrEP we are failing those who are at risk of HIV” he said. “Today’s decision by NHS England to depart with due process, and, instead, offer a tokenistic nod to what has the potential to revolutionise HIV prevention in the UK, is shameful.”
He continued: “£2 million over two years for 500 gay men ‘most at risk’ is an arbitrary figure which seems ill thought out and will still deny the protection that PrEP offers to the people who most need it. We know that PrEP works and already have substantial data from a real world setting from the PROUD trial. PrEP has already been approved in the US, Kenya, Israel, Canada, France.
“And yet, our own government refuses to take responsibility for PrEP. Today’s statement makes it no clearer who is responsible – is it the Department of Health, local authorities, the NHS or Public Health England?
“We need answers , we need access, and we demand both.”
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