Today a High Court judge handed down his ruling NHS England has a ‘preventative role’ and ‘the power to commission preventative function’. While this might not sound significant it’s actually a pretty big moment, for those of us campaigning for access to PrEP.
We’ve known PrEP is incredibly effective at preventing HIV for a few years now, but the access to it has been limited to those who are financially able, and willing, to buy it online from abroad. When NHS England abandoned a consultation to commission PrEP it was left to the community to fight for access, and fight we did.
The National AIDS Trust mounted a legal challenge against NHS England, who were claiming they didn’t have the right or power to commission preventative functions, and today the judge found in favor of the National AIDS Trust. The NHS can commission PrEP, but that doesn’t mean they must.
Much of the argument has been about the cost of Truvada, the drug used as PrEP, currently priced at around £400 per month. It isn’t cheap, but within a year or so we should be able to buy a generic version for around 20% of that price.
But even if the price were to stay at £400 the cost savings of a person being on PrEP for a couple of years vastly outweigh the cost of treating someone for HIV over their lifetime – somewhere in the region of £350,000.
We’ve also seen the old ‘just use a condom’ rhetoric dragged kicking and screaming out of a dusty memory box. This is an argument that continues to perplex me. Condom use has been consistently high for the last 30 years, and continues to be so – yet in 2014 we had 6,151 new HIV infections in the UK alone.
There are also situations where condoms just aren’t going to work. We have people in sexually abusive relationships, people in relationships where they don’t get to control how safe their sex is, people who sell sex, people who have issues around sober sex – be that drugs or alcohol, people with mental health issues, and trans* people who are disproportionately affected by HIV and have real issues negotiating safer sex. Then there are just the times you plain forget to use one, or don’t have any on you. Condoms are great but they’re not the whole picture, not then, not now.
PrEP isn’t for everyone but for those who taken it it can often be a life changer. I have several friends who are on PrEP, it has given them a whole new confidence when negotiating sex, and taken away an almost paralyzing fear of contracting HIV. PrEP, when prescribed properly, can be an amazing tool – one that can change lives and one that can save lives.
We should give a cautious welcome to the news from the High Court today, it’s a step in the right direction – but it’s also tinged with disappointment as we’ve heard that NHS England plan to appeal the decision, an appeal that will cost tens of thousands of pounds, if not more.
Perhaps that money would be better spent on PrEP rather than on a fighting a losing battle, that reeks of institutionalized homophobia, to deny people access to safer and healthier sex lives?