England must have full access to the drug that stops people getting HIV
PrEP transforms lives. The drug must have a permanent home within England’s sexual health services, writes Lloyd Russell-Moyle MP
Last year I marked 10 years since I became HIV positive. It has been a long journey, from the fear of acceptance and today, advocacy, knowing that my treatment keeps me healthy and prevents HIV being passed on to any partner.
With the developments in pre-exposure prophylaxis (PrEP), a daily tablet which can stop a person from getting HIV, we have a real chance of ending HIV transmissions.
Robust scientific evidence has shown that PrEP is highly effective at preventing HIV. Yet, England is the only place in the UK where access to PrEP is restricted. Organisations including Terrence Higgins Trust and the British HIV Association are clear that this needs to change. England has lagged behind on PrEP for far too long.
The PrEP Impact Trial was launched across England in October 2017 with 10,000 places available. Due to soaring demand, the trial places were increased by an extra 3,000 in September last year.
In January, the secretary of state Matt Hancock committed the UK Government to end new HIV transmissions by 2030. To assist this aim he promised to double the number of places on the PrEP Impact Trial, with NHS England agreeing to fund the cost of the drug for these extra places.
The trial comes to an end in September 2020. Demand remains high, and we must ensure that while the trial remains in place no one is turned away from accessing PrEP.
The Government must also now turn their efforts to ensuring that PrEP has a permanent home within sexual health services. In the past few months NHS England, Public Health England, local authorities and even the Department of Health and Social Care have said there must be a smooth transition between the trial and routine commissioning of PrEP.
A national PrEP programme needs to be introduced by April 2020 to ensure that those currently on the trial don’t face a cliff edge in September 2020.
We all are aware of the budgetary pressures faced by councils as a result of continued cuts to public health budgets. The tension around funding is tricky. The reality is that NHS England are funding the PrEP drug, but it’s local authorities that fund sexual health clinics.
When the Impact Trial started, only the branded PrEP drugs were available. Now it’s available as the generic version – at a fraction of the price. But the reality of creating more sexual health appointments when the funding has been cut is a very real challenge. However, this cannot justify the withholding of a tool that we know can prevent HIV.
We now know that at least 15 men have contracted HIV while waiting for a place on the trial. And this is likely to be the tip of the iceberg. This is the reason why I am urging the Department of Health and Social Care, NHS England, Public Health England and local authorities to work together to find a viable and stable future for PrEP as a national programme.
If we are to have a smooth transition, the challenges facing routine commissioning must be ironed out and resolved sooner rather than later.
As Phil Samba, a PrEP activist puts it: “PrEP means that I can finally feel completely in control of my sexual health for the first time. No one should be turned away from this HIV game-changer and it must be routinely available.”
PrEP works. PrEP saves the NHS money in treatment costs. PrEP will help us end HIV transmissions. PrEP transforms the lives of people at risk of HIV. So why the hell are we still waiting for full access to this game-changing drug?
Lloyd Russell-Moyle is Labour Co-op MP for Brighton Kemptown
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