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The Terrence Higgins Trust (THT), a British charity providing services relating to HIV and sexual health, has expressed doubt over the government’s ability to meet its deadline of making pre-exposure prophylaxis (PrEP) routinely available on the NHS in England from April 2020.
PrEP is currently provided in England through the three-year PrEP Impact Trial, which began in September 2017.
Matt Hancock, the health and social care secretary, said during health questions in the House of Commons in October 2019: “The rollout from a trial to routine commissioning will happen in April [2020]”.
However, he also conceded at the same time that “there are some gaps where local authorities need to do more”.
The THT has said that it is “entirely unclear” how the timetable will be achieved.
“The government has confirmed its intention to make PrEP routinely available in England from April, which is absolutely the right decision and vital as we aim to end HIV transmissions over the next decade,” said Debbie Laycock, head of policy at THT.
“But it’s now late February and — despite all of the government’s rhetoric on the importance of prevention — it’s entirely unclear how this timetable is going to be stuck to or how PrEP will be effectively delivered.”
Laycock said that the current PrEP trial was being delivered by sexual health services that were already “overstretched”, meaning that, for PrEP to be maximised for HIV prevention, sexual health services must be fully funded to deliver equitable access to PrEP.
In June 2019, more than a quarter of the sexual health clinics involved in NHS England’s PrEP Impact Trial were closed to new recruits, despite a promised expansion of the trial.
“We have been vocal campaigners for PrEP to be made fully available since it was proven to be so effective in preventing HIV transmission,” she added.
“We are now continuing to hold the secretary of state for health and social care to account on his commitment in October [2019] to have routine commissioning of PrEP from April 2020.
“This includes ensuring a seamless transition for those accessing PrEP via the current impact trial. There’s also work needed to ensure any wide-scale PrEP programme is fit for purpose and all groups impacted by HIV are aware of its vast benefits.”
A spokesperson for the Department of Health and Social Care said: “We are working with NHS England and [NHS] Improvement, Public Health England and local authorities to plan for the commissioning of PrEP from April 2020”.
NHS England and NHS Improvement will fund the ongoing costs of PrEP. Information on how other elements of the programme will be funded and how commissioners will be supported is expected to be published soon.
NHS England started its PrEP Impact Trial in September 2017 to provide PrEP to people at high risk of HIV infection in England, in order to gather clinical evidence on optimal targeting, uptake and implementation of PrEP on a large scale.
In August 2018, the THT announced that it would be launching a PrEP access fund to support up to 1,000 people in England and Northern Ireland who could not access or afford the drug.
