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NHS England pulling the plug on PrEP for HIV prevention is unacceptable

I wish to draw your attention to NHS England’s sudden abandonment of its own processes in a shocking U-turn on access to HIV game changer pre-exposure prophylaxis (PrEP; emtricitabine/tenofovir, marketed as Truvada).

The HIV sector has been waiting for the announcement of the first ever public consultation on PrEP since the end of January 2016. This was one of the final steps before a decision would have been made on NHS availability for PrEP — already available in the United States, France, Canada, Israel and Kenya.

The consultation response would have formed part of a submission to the Clinical Priorities Advisory Group (CPAG), the body that it had been thought would say ‘yes’ or ‘no’ to PrEP at its next meeting in June 2016. Instead, NHS England has announced there will be no public consultation and all the work to date has been discarded.

For the past 18 months, charities, academics and patients have been lulled into a false sense of security. NHS England has been involved in all the discussions on PrEP. We had expected it to go to a public consultation, be commissioned and rolled out with guidance by the end of the year.

NHS England pulling the plug at this stage leaves people at risk who would otherwise have been protected. The reality is that condoms are not working for everyone. If they were, eight gay men would not be infected with HIV in the UK every day, as is the current situation. This is an epidemic.

We know PrEP works and we need it as an option to help in prevention of this epidemic. We urge our government to step in and take control. The NHS announcement infers it is local authorities — who are not early implementers — that take on PrEP in its entirety.

This is just not possible, and betrays a complete lack of understanding by the NHS. In fact, the Local Government Association has come out strongly against the NHS decision. We need an alternative commissioning process and budget to examine the work on PrEP so far, and a clear and thorough rationale on a decision to fund PrEP for those who need it on the NHS.

Right now no one will take responsibility for PrEP and time is ticking by. Meanwhile, back in reality people are needlessly becoming infected with HIV; infections that could be avoided with access to PrEP for those at risk.

We are demanding that the government take control of the situation. We will not rest until we have access to PrEP for those who need it.

Ian Green

Chief executive officer

Terrence Higgins Trust

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2016.20200920

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