Pre-Exposure Prophylaxis (PrEP) involves HIV negative people taking an antiretroviral drug to avoid getting HIV. Multiple studies around the world have shown PrEP to be effective in reducing the risk of contracting HIV. After a lengthy review process, during which all the indications were good, the NHS announced that it would not after all commission PrEP in England.

The National AIDS Trust (NAT) has said that it plans to seek a judicial review of NHS England’s decision on pre-exposure prophylaxis (PrEP).

The full background can be found here.

Deborah Gold of NAT commented: “NHS England is sitting on something that could be the beginning of the end for the HIV epidemic – if only it were made available. The refusal to commission it for all those at significant risk is astonishing.”

“There is an easy answer,” commented Simon Collins of HIV i-Base. “The Secretary of State can authorise access to PrEP – which has already passed public consultation and review – and fund it out of the numerous contingency budgets available for crisis situations.”

In the House of Commons last week, public health minister Jane Ellison faced a hostile and protracted grilling by MPs on the issue. Fifteen MPs rounded on the minister variously accusing her, the government and NHS England of “having their head in the sand”, of “passing the buck”, and of being “incompetent”.

Andrew Gwynne MP said: “Seventeen people are diagnosed with HIV every day. Each year, there are thousands of new infections. We know that PrEP has the potential to be a game-changer ­– yet as a result of this latest decision, this life-changing drug will remain inaccessible to people at risk of HIV.”

Jane Ellison announced that NICE (the National Institute for Health and Care Excellence) would be asked to review the scientific evidence on PrEP over the next few months. NICE will provide a critical review of the strengths and weaknesses of the existing scientific evidence, especially of cost-effectiveness. The review is designed to help decision makers but will not be formal NICE guidance. But campaigners are concerned this could be a delaying tactic. Ian Green of Terrence Higgins Trust said: “Enough time has already been wasted. The NICE review into PrEP is yet another unnecessary layer of bureaucracy standing between those at high risk of HIV and the drug that could stop them from getting the virus.”