PrEP, HIV and the NHS: What You Need to Know

by Loz Kaye, Open Intelligence Think Tank Co-Founder

Another victory in the fight against HIV / AIDS has been won in the UK. The High Court ruled that the health service in England can fund PrEP (pre-exposure- prophylaxis), a daily pill which can prevent people being infected with HIV. This was following pressure from campaigners for Britain to roll out the “game changer” treatment. Why the controversy over PrEP, HIV, and the NHS?

Having claimed it did not have the power to provide the pill Truvada, NHS England argued that it was the job of local government which has control over preventative public health measures. The judge found this was not the case and the National AIDS Trust greeted the decision as “fantastic news”. You would think the issue with PrEP, HIV, and the NHS would be resolved.

PrEP, HIV, and the NHS Controversy

Sadly some of the reaction to the PrEP ruling seemed to come straight from the bad old days of the AIDS crisis. The Daily Mail fumed about a “promiscuity pill”, a “lifestyle drug” and “a skewed sense of values”. Others sought to pit different treatments and diseases against each other. Worst of all that included the NHS, warning of potential cutbacks to drugs for children with cystic fibrosis for example. What all the controversy ignores is the most important point. PrEP works.

The US Centers for Disease Control and Prevention say that PrEP can reduce the risk of HIV by up to 92%. One study conducted in San Fransisco found 100% of participants remained HIV-free. That’s not to say there aren’t issues about people taking pills consistently, as with any drug. But PrEP can have a crucial role to play if prescribed in a focused group of patients. The CDC modeled 33% of new infections could be avoided over 10 years with the right prescribing.
What all the funding controversy ignores is the most important point. #PrEP works. Click To Tweet

PrEP, HIV, and the NHS’s Priorities

PrEP is not about any individual’s “lifestyle”. Without a viable HIV vaccine, it is about the best option we have currently of eliminating HIV by halting transmissions. Preventing infection has to be a priority when numbers living with HIV continue to rise. Reversing that trend will be good news for gay and bi- men, but of course it will also be good for everyone. Our health is not separate from the rest of the nation, whatever the Daily Mail thinks.

NHS England’s response has been disappointing, particularly as they intend to appeal the ruling. We all understand the pressure on budgets, but they risk giving the impression they are not taking gay and bisexual men’s health seriously. This feeds the stigma which so frustrates the work on HIV / AIDS.

PrEP, HIV, and the NHS’s Goals for Health

This is the time for clear goals. Health service leaders should insist election promises of saving NHS funding are made good, not play one patient group off against another. Political leaders must realise that action on HIV is still needed, and PrEP will be part of that.
The health services goal for #HIV must be zero transmissions, zero deaths, zero stigma. Click To Tweet
The goal on HIV / AIDS has to be mission zero. Zero transmissions, zero deaths, zero stigma. If that’s not the goal of health services and government in the UK, and worldwide, they need to be honest. Because we will take up the fight again for the sake of our own health and everyone else’s.

Loz Kaye has spoken widely on mass surveillance, digital rights and intellectual property, with appearances on the BBC, CNN and Russia Today amongst others. He’s based in Manchester where he is involved in community activities – in particular fighting for green space and supporting the LGBT community.

A CDC PrEP infographic from the Act Against AIDS campaign brochure.