NHS England has reiterated that it will not fund pre-exposure prophylaxis (PrEP) for HIV prevention.
This decision was first announced in March 2016, but pressure from stakeholder groups pushed NHS England to convene a meeting of the specialised services commissioning committee to reconsider it.
However, the committee concluded that it agreed with the original decision that NHS England does not have the legal power to commission PrEP, which is a way of using antiretroviral drugs to stop viral transmission, and that this responsibility lies with local authorities.
This decision was based on legal advice from external advisers to NHS England, which also said that a decision to include PReP in a competitive commissioning process could leave them open to legal challenges from proponents of other treatments and interventions.
Ian Green, chief executive of the Terrence Higgins Trust, says the decision is “shameful”.
“This country used to lead the way in the fight against the HIV epidemic but, today, our national health service has washed its hands of one of the most stunning breakthroughs we’ve seen – a pill which, if taken correctly, is almost 100% effective in preventing HIV. A pill that is already available in the United States, Canada, France, Kenya and soon to be Australia.
“It’s not right that people who know themselves to be at high risk of HIV have to buy PrEP themselves from the internet at considerable personal expense,” he adds. “Currently, only those who can afford it are able to access this life-changing treatment, further widening the inequality gap by those most affected by HIV.”
NHS England says it still plans to make £2m available for a project run in conjunction with Public Health England that will explore the feasibility of PrEP commissioning at test sites. As part of this, PrEP will be available to 500 men at high-risk of HIV transmission.