This drug could halt HIV - so why has the NHS decided to turn its back on it?

The NHS has refused to commission the drug that could halt the spread of HIV – why are they prepared to put so many people's lives at risk?

NHS England has said the responsibility to fund PrEP lies with local authorities (Alexander Raths/iStockphoto)

Every day 17 people are diagnosed with HIV in the UK. And yet NHS England has pulled the plug on commissioning a revolutionary drug, PrEP, which can stop the HIV infection. NHS England’s isn’t just washing its hands of PrEP – it is washing it’s hands of people in this country who need the drug now.

To clarify, PrEP is a prevention drug that, if taken in the correct manner, stopped users contracting HIV – in a recent trial, no infections occured when the drug was used properly. This is revolutionary, and could free individuals from the burden of contracting it. Considering that transmission of the disease is at a staggering high, with around 2,800 men who had sex with men infected with HIV in 2014 alone, that’s eight HIV infections a day that don’t have to happen.

Individuals who were a part of the PROUD trial, which assessed the effectiveness of the drug, often say that PrEP allows them to feel free from fear. This relief from anxiety is an important aspect of what this drug can offer.

Now let's be clear – HIV can affect anyone, regardless of sexual orientation, race or gender. While it is prevelant in the gay community, 1 in 1,000 straight people have the disease, with the number rising for black African men and women. This is a treatment that would benefit many and will reduce the impact of HIV across society, but is needed most within the high risk categories – and it's pitiful that the NHS doesn't see this as a just reason to commission the drug.

After a sharp intake of breath, charities committed to the fight against HIV felt they could temporarily breathe again when NHS England agreed to reconsider their decision following the threat of legal action. But the relief was short lived. On 31st May, NHS England reconfirmed that they believe they do not have the power to commission PrEP. The decision has been universally condemned.

NHS England say they can’t legally commission PrEP as it is a prevention intervention and, along with public health, prevention (as opposed to treatment) is the responsibility of local authorities.

However, while it is true that the main responsibility for prevention rests with local authorities, it is not their sole responsibility. NHS England also has a clear role in prevention – it commissions immunisations and vaccines on a regular basis.

It is believed, and legal advice confirms, that there is nothing to prevent the NHS commissioning PrEP – should it wish to do so. NHS England already purchases HIV drugs for treatment, and for prevention for those that think they have been exposed to the virus (PEP).

In fact the buying power of the NHS offers by far the most cost-effective mechanism for purchasing the drug. And if the NHS won’t fund PrEP, who will? The reponse of local authorities to this decision suggests they are not keen to push forward with funding it – and with the cuts to public health budgets who can blame them?

The NHS has made a tokenistic offer of PrEP for 500 gay men. It’s simply not good enough to offer the drug to a small, concentrated group, and forget about the other thousands of individuals who could contract the infection.

PrEP has the potential to be the beginning of the end for HIV. It’s too good an opportunity to miss.

Kat Smithson is a policy and campaigns manager for the National Aids Trust (NAT)