Views

Some readers will recall the campaign NAT led at the end of 2014 to prevent national HIV prevention spending being cut by 50%. We were successful – and last year in 2015/16 the overall amount spent by central government remained more or less stable at £2.4 million. But what now are the plans for the current year, 2016/17? NAT wrote to Public Health England (PHE) to find out. One thing is clear… not enough is being done in England to prevent HIV transmissions.

NAT responds to the Government announcement of a NICE Evidence review on PrEP

Jane Ellison MP, Parliamentary Under-Secretary of State for Public Health, announced on Tuesday 7 June in the House of Commons a NICE Evidence Review to look into the case for PrEP, and in particular its cost-effectiveness. The review should report in advance of the previously announced £2m pilot towards the end of the year, and will apparently feed in to that pilot.

In 2014 3,346 people across England and Wales died because they had a drug overdose. This is the highest number since records began and in England this represents a 17% rise from the previous year, a dramatic deterioration of the situation for people who use drugs in this country.

In March, NHS England announced it was pulling the plug on an 18 month process to decide whether or not to fund pre-exposure prophylaxis (PrEP) for HIV.

Rarely has a u-turn, rarely has a breach of trust, been so misleadingly announced. Reading NHS England’s press release, ‘Update on commissioning and provision of PrEP for HIV prevention’ (21 March 2016), you would think the NHS were simply clarifying progress to date and the well understood responsibilities for the commissioning of PrEP. In fact this press release was the announcement of a shocking U-turn as NHS England suddenly abandoned its own process for the approval of PrEP, just before its conclusion, with nothing to replace it bar some loose change found down the back of the sofa.

Reducing new HIV infections has been a priority in the UK ever since the epidemic’s outbreak. It’s taken so seriously the vast majority of ways to prevent infection are free to those who need them. Condoms and lube can be accessed for free, people who inject drugs should have access to free injecting equipment through Needle and Syringe Programmes, and people can begin HIV treatment (also free) immediately if this reduces their risk of passing on HIV to others. These methods have and will continue to contribute to the UK’s relatively successful response to the epidemic.

In my last blog I welcomed PHE’s new tender for a national HIV prevention programme. The annual value of the programme is £1.2 million, the same as the value for HIV Prevention England in 2015/16. In the current context of significant cuts to the public health budget announced by the Chancellor in his Spending Review, to maintain the programme’s value is an achievement, and absolutely necessary given experts agree that HIV incidence is increasing.

Part One. Just before the Christmas holidays Public Health England (PHE) released their tender documentation for a new national HIV prevention programme, to last for three years from 2016/17, with the possibility of extensions for a maximum of a further two years.

Recently-released official statistics show that last year, there were just over 85,000 people accessing HIV treatment and care in the UK. Almost all (91%) of this group were on antiretroviral treatment (ART) and 95% of those on ART had achieved ‘viral suppression’ – this means HIV can no longer be detected in their blood and they can consider themselves ‘non-infectious’.