Health and Social Care Secretary Matt Hancock has confirmed that NHS England will fund and roll out PrEP to those at risk from October 2020.
PrEP, which stands for Pre-Exposure Prophylaxis, is a single pill comprising of the drugs Tenofovir disoproxil and Emtricitabine. Taken either daily, or on an event basis, these drugs have proven to more than 99% effective at preventing a HIV negative person acquiring HIV.
Currently PrEP is available on the NHS in Scotland and Wales but up until this point had only been available in England on the IMPACT trial. The trial was started in October 2017 as a stop-gap solution until a decision was made on commissioning and has been fraught with issues such as limited places and the allocation of those places to specific regions and groups.
The statement from the Department of Health and Social care reads:
The funding from the Department of Health and Social Care will ensure anyone who is at a high risk of contracting HIV will receive PrEP from their local sexual health clinic to reduce their risk of getting the virus.
The new £16 million funding will also enable people on the trial to continue to use PrEP when the trial ends.
NHS England will cover the costs of the drug and local authorities will be supported with £16 million funding to deliver services. PrEP is highly effective in preventing transmission of HIV.
As well as the provision of PrEP, HIV testing in a wide range of settings, increased condom use and the early starting of antiretroviral therapy in those living with HIV have all contributed to the drop in transmissions.
By the end of October 2020 access to PrEP through the PrEP Impact Trial is set to conclude and so the rollout will make the service available by routine commissioning for the people who need it most.
HIV and sexual health activists and advocates reacted with joy this morning as the news broke.
Musician and long-time HIV activist Elton John said this morning that he was “overjoyed” and that it was “truly incredible.” The Elton John AIDS Foundation (EJAF), founded in 1992 in the US and 1993 in the UK, has been a long-time funder of PrEP access and campaigning groups.
HIV and Sexual Health Consultant, and founder of the Saving Lives charity, Doctor Steve Taylor told beyondpositive: “This is THE crucial development that HIV prevention specialists have been fighting for. Without the availability of PrEP in addition to condoms and test & treat strategies we could never achieve the elimination of new HIV transmissions by 2030”
Deborah Gold, Chief Executive Officer of NAT said in a statement: “We’re delighted PrEP will finally be freely available to all those who need it in England, with no cap on spaces.
“This is a milestone moment in a five-year battle National AIDS Trust, along with other organisations and countless activists, has undertaken. This included our 2016 court action against NHS England for failing to consider PrEP and HIV prevention as part of their obligations.
“It’s been clear for a long time that the trial could not meet demand for PrEP, with spaces at some clinics filling up fast. Routine commissioning is needed urgently to increase access and provide much needed certainty to those on the trial.“
Marc Thomspon, co-founder of the PrEP access movement PrEPster commented: “We support calls for robust and proper investment in our creaking sexual health services, including proper investment in clinical services, peer services, and health promotion programmes. Those services are facing the fallout of austerity and we should have a sexual health service that can provide PrEP – and all other sexual health services – to everyone who needs them.”
Phil Samba, Strategic Lead for Queer Men of Colour at PrEPster said: “It is vital that the new PrEP service does not reinforce current health inequalities. Investment must be increased to ensure that those who most need PrEP know about it, can access it, and – where appropriate – are supported in using it.”
Jason Domino, sex worker rights campaigner and founder of The Domino Foundation added that: “The PrEP rollout is exciting but without the decriminalisation of Sex Work then sex workers in “underground” conditions like temporary pop-up brothels, with issues like language barriers, may still not be safe when accessing information about PrEP.
“This could lead to employers poorly explaining PrEP to sex workers leading to harm to those sex workers – such as the long term effects from an undiagnosed STI or unwanted pregnancies with the associated unsafe abortions.
“This means as part of a PrEP rollout there is a governmental obligation to look at the decriminalisation of sex work to help bring workers above ground where tools like PrEP can be safely explained and accessed.”
It is worth noting that this initial £16m is only to cover the period October 2020 to October 2021. There is currently no commitment to continued support beyond that point, but campaigners remain cautiously optimistic that funding will be ongoing once commissioned.
Link to Government statement: https://www.gov.uk/government/news/hiv-drug-prep-to-be-available-across-england
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