NHS England attacked for ‘U-turn’ on new HIV treatment

HIV campaigners have slammed the decision by NHS England not to fund a new treatment that can prevent the spread of the virus.

With proven success, Pre Exposure Prophylaxis (PrEP) is a new way of using antiretroviral drugs, which if taken properly can be effective in stopping transmission in almost every case.

Over the past 18 months stakeholders from the HIV sector, as well as Public Health England, NHS England and the Department of Health, have been working on ways to fund the drug.

A spokesman for NHS England confirmed that they were considering the specialised commissioning budget as a way of potentially funding of PrEP as part of this process.

But on Monday they said that because the new treatment has been established as a preventative service the drug will not be funded out of this pot.

Under the terms of the Health and Social Care Act, the spokesman said responsibility for prevention, and therefore the decision whether to fund and commission the drugs, falls with local authorities.

Director of strategy at the National Aids Trust, Yusef Azad, called the announcement a complete U-turn and that PrEP from the outset has been considered a preventative treatment.

He added: “We have known since 2012 that the main responsibility for prevention services lies with local councils.

“But NHS England also does prevention – it does immunisation and vaccinations. NHS England led us to believe for the last two years that they would be willing to commission and fund PrEP as long as it met the appropriate criteria of cost effectiveness.”

Mr Azad called the decision “another example of our health system refusing to fund prevention effectively”.

He added: “Many people have spent 18 months on an official NHS working group developing the case for PrEP – only to find just before the final decision the whole process torn up and abandoned.

“No alternative and appropriate decision-making process for PrEP has been proposed, just an inadequate and arbitrary amount of funding for the next two years,” said Mr Azad.

“At the moment for every £55 we spend on HIV treatment we spend just £1 on HIV prevention.

“Until we change the balance and start taking prevention seriously we are still going to see many lives seriously affected by HIV.”

A statement on the NHS England website reads: “As set out in the Local Authorities (Public Health Functions and Entry to Premises by Local Healthwatch Representatives) Regulations 2013, local authorities are the responsible commissioner for HIV prevention services.

“Including PrEP for consideration in competition with specialised commissioning treatments as part of the annual CPAG prioritisation process could present risk of legal challenge from proponents of other ‘candidate’ treatments and interventions that could be displaced by PrEP if NHS England were to commission it.”

NHS England also announced it would make £2 million over two years available to help provide protection to an additional 500 men who are at high risk of infection.

Ian Green, Terrence Higgins trust CEO, said by denying the full availability of PrEP, those who are at risk of HIV are being “failed” and called the cash promise a “tokenistic nod” – especially when 2,500 men are diagnosed with HIV every year.

He added: “£2 million over two years for 500 gay men ‘most at risk’ is an arbitrary figure which seems ill thought out and will still deny the protection that PrEP offers to the people who most need it.

“We know that PrEP works and already have substantial data from a real world setting from the PROUD trial. PrEP has already been approved in the US, Kenya, Israel, Canada, France.

“And yet, our own Government refuses to take responsibility for PrEP.

“Their statement makes it no clearer who is responsible – is it the Department of Health, local authorities, the NHS or Public Health England?

“We need answers, we need access, and we demand both.”

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