Flawed decision from NHS England on pre-exposure prophylaxis (PrEP) for HIV prevention

Like the countless people affected by HIV in the UK, we are angry and confused by the decision of NHS England to halt its work to ensure that pre-exposure prophylaxis (PrEP; (emtricitabine/tenofovir, marketed as Truvada), which drastically reduces the chance of infection with HIV, is available on the NHS. We know that PrEP is efficient and cost-effective and we share the frustration that NHS England has pulled the plug on more than 18 months of hard work.

Rather than implementing a long-term policy to ensure all who need PrEP will have access, there will instead be £2m allocated over two years for 500 gay men “most at risk”. We question how this arbitrary amount of money and the lucky number of 500 PrEP recipients were decided. More than 5,000 gay men will get HIV over the next two years. Many of these men would not have faced a life with HIV if PrEP had been delivered as proposed. Not to mention, 500 does not come close to covering the number of gay men at high risk of HIV nor does it address the needs of heterosexuals at risk.

We know PrEP works, so the claim from NHS England that more trials and answers to further questions are required is simply wrong. San Francisco saw a 30% drop in HIV diagnoses since the introduction of PrEP in 2012. The United States, Canada, France, Israel, Kenya have all made PrEP available, so why has the NHS failed to deliver this effective prevention tool?

Why was the decision, which was to consider the results of months of hard work, analysis, and testing in June 2016 at a formal panel thrown aside? There is no clarity as to who is responsible to commission and fund PrEP in the long-term, but we cannot allow it to be in limbo for a further two years.

We call on ministers to intervene and reverse this outrageous decision and to secure a clear and strategic process that will provide PrEP on the basis of evidence and need.

Deborah Gold

Chief executive

National AIDS Trust