NHS England has announced  that local councils will be responsible for funding the new HIV treatment PrEP.

This is a missed opportunity to launch a ground-breaking prevention method that could halt the spread of HIV, potentially save lives, and make a significant breakthrough in reducing the risk of HIV infection. Councils have invested millions in providing sexual health services since taking over responsibility for public health three years ago, and this treatment could help reduce levels of HIV in the community.

It is also not right that councils should be made to foot the bill. In stating that local authorities are responsible for commissioning HIV prevention, NHS England adopts what is, in our view, a wholly inadequate position.

During the transition period to implementation of the NHS and Care Act 2010, NHS England sought to retain commissioning of HIV therapeutics, which the PrEP treatment clearly falls into.  It is, and should remain, an NHS responsibility unless it is fully funded for local authorities to pass on.

NHS England’s statement is a selective and untenable reading of the Public Health Regulations 2013 and an attempt to create a new and unfunded burden on local authorities.



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One Comment

  1. Roy Trevelion says:

    The National AIDS Trust (NAT) Director of Strategy, Yusef Azad, who has spent 18 months working with NHS England on the PrEP decision-making process has written a blog explaining exactly what went wrong and what should happen now:

    ‘The NHS has just announced it has pulled the plug on its decision-making process on whether to offer PrEP (a HIV prevention drug, proven to be effective in stopping HIV transmission in almost every case if taken properly) on the NHS. This is a real shock.

    Deborah Gold, Chief executive of NAT, said: “NAT shares the anger and distress felt by many thousands of people across the country at NHS England’s decision to abandon its work to provide PrEP, near the very end of the process. In a shocking U-turn, NHS England has pulled the plug on over 18 months of hard work which demonstrated the need, efficacy and cost-effectiveness of PrEP.

    “Instead of a long-term policy to give PrEP to all who need it, there will be £2 million over two years for 500 gay men ‘most at risk’. The decision is not informed by any due process; the amount of money is arbitrary; the claim that more ‘testing’ of PrEP is needed is disingenuous. 500 does not remotely cover the number of gay men at high risk of HIV nor meet the needs of heterosexuals at risk. There is no clarity within the Department of Health, the NHS or Public Health England as to who long-term is responsible to commission and fund PrEP.

    This is simple maladministration with serious consequences. Over 5,000 gay men will get HIV over the next two years – very many of whom would not have done so if PrEP had been delivered as proposed.

    The US, Canada, France, Israel, Kenya have all made PrEP available. Faced with one of the most exciting prevention options to emerge since the HIV epidemic began, and which offers the prospect of real success in combatting this virus, the NHS has failed miserably to deliver.

    We call on Ministers to intervene and reverse this deplorable decision – securing a process to provide PrEP on the basis of evidence and need.” ‘

    I agree with NAT,

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