NHS England won’t be rolling out HIV-preventing PrEP drugs

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NHS England has again declined to commission HIV-prevention drugs that can drastically reduce transmission.

Pre-Exposure Prophylaxis (PrEP) drug Truvada can reduce people’s chances of being infected with HIV by up to 99 percent, if taken daily.

The drug has been endorsed by the World Health Organisation and is already routinely available to at-risk gay men in a number of countries, including the United States, Canada, France and Israel.

In the UK, NHS England is currently re-considering whether it should make the drugs available after initially seeking to stall the issue – after a pilot scheme showed the drugs were incredibly effective at reducing HIV transmission among men who have sex with men (MSM).

In a first for a world leader, Prime Minister David Cameron had last week intervened by calling for the NHS to “reach a decision on this quickly”, suggesting “these treatments can help and make a difference.”

However, NHS England has again declined to commission PrEP – again suggesting a further small-scale trial at “early implementer” cites instead of a roll-out, despite ample evidence of its efficacy.

A statement said: “In light of representations from stakeholder groups NHS England agreed to reconsider the decision.

This took place on 31 May 2016 at the Specialised Services Commissioning Committee.

“In summary, the Committee considered and accepted NHS England’s external legal advice that it does not have the legal power to commission PrEP.

“[The committee] remains committed to working with other commissioners to explore the possible provision of PreP.

“This includes working in partnership with Public Health England to run a number of early implementer test sites, backed with up to £2m investment over the next two years, to research how PrEP could be commissioned in the most clinically and cost effective way.”

HIV activists attacked the “shameful” decision.

A statement from the National AIDS Trust says: “PrEP is an HIV prevention drug, proven to be effective in stopping HIV transmission in almost every case if taken properly.

“The decision by NHS England not even to consider commissioning PrEP came after 18 months of hard work from an NHS working group (comprising clinicians and experts from across the HIV sector) which demonstrated the need, efficacy and cost-effectiveness of PrEP.”

NAT exec Deborah Gold said: “NHS England is sitting on something that could be the beginning of the end for the HIV epidemic – if only it were made available.
“The refusal to commission it for all those at significant risk is astonishing.

“Seventeen people are being diagnosed with HIV every day. We are extremely disappointed and we will now be looking at our options, including further legal action.”

Ian Green, Chief Executive of Terrence Higgins Trust, said: “Today is a shameful day for HIV prevention. This country used to lead the way in the fight against the HIV epidemic, but today, our national health service has washed its hands of one of the most stunning breakthroughs we’ve seen; a pill which, if taken correctly, is almost 100% effective in preventing HIV. A pill which is already available in America, Canada, France, Kenya and soon to be Australia.

“How did it come to this? It defies belief that, after 18 months of false hope, delays and u-turns in the battle to see PrEP made available on the NHS to people at high risk of HIV, today we are in a worse position than when we started.

“It is a mess, and the people who will feel the effects are the 2,500 men who have sex with men who will be needlessly infected with HIV each year in the UK. This figure has not changed in a decade. Who will claim responsibility for the life-long impact this will have on people’s lives?

“It’s not right that people who know themselves to be at high risk of HIV have to buy PrEP themselves from the internet at considerable personal expense. Many high risk people are living in poverty and they simply cannot afford to protect themselves against HIV. Currently, only those who can afford it are able to access this life-changing treatment, further widening the inequality gap by those most affected by HIV.

“The battle for PrEP must continue until the day that people at highest risk have access to this groundbreaking pill that will protect them from HIV.”