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Dear Matt Hancock. No more grandiose gestures, we demand action on PrEP in the UK

Natasha Dhumma January 30, 2020
Health secretary Matt Hancock was urged to roll out PrEP in England

Health secretary Matt Hancock was urged to roll out PrEP in England. (WIktor Szymanowicz/NurPhoto via Getty Images)

Natasha Dhumma, head of policy and campaigns at the National AIDS Trust, explains for PinkNews why the British government’s sluggish approach to PrEP must be held accountable.

Today marks exactly one year since the health secretary Matt Hancock proudly announced that the government had set itself the goal of ending new HIV transmissions in England by 2030, thereby becoming one of the first countries to reach this UN target.

It is a bold ambition but entirely achievable if backed up by advances in prevention, testing and treatment.

Unfortunately, however, that when it comes to PrEP – the highly effective medication to protect individuals from getting HIV and perhaps the most vital tool we can equip ourselves with to realise this goal – the government seems to be failing in its first test.

The struggle to make PrEP available through the NHS has been fought for much more than a year.

We have endured a five year uphill battle that has included taking the NHS to court, the complications of the ongoing PrEP trials (where places are tightly capped), and repeatedly pushing for more places to be freed up in order to match demand that so clearly exists within impacted communities.

This is without counting the hours spent on working groups and alliances NAT has been a part of to make PrEP happen.

(Daniel Born/The Times/Gallo Images/Getty Images)

Ongoing funding disputes around who should foot the bill for associated costs have routinely slowed down and complicated the process.

At times it feels like a herculean effort to overcome and laid bare the shortcomings of a fragmented and unwieldy healthcare system where the NHS is responsible for providing medication but local councils prescribe and monitor PrEP through sexual health clinics and are struggling with increasingly squeezed budgets.

With so many key players who often don’t talk to each other, finger pointing ensues and delays proliferate. We have come so far in making PrEP a reality it is unforgivable if we fail now.

A genuine partnership approach is essential in making real this commitment.

It’s not to say that the importance of PrEP has gone unnoticed by the government.

In the autumn of 2019, Hancock and public health minister Jo Churchill both committed in parliament to implementing routine commissioning by April 2020 – six months before the current IMPACT Trial is due to end.

This commitment was restated yesterday but with very little detail on how exactly it will happen. With less than three months to go until the April deadline the community needs to hear concrete solutions.

For while it’s given us a year’s worth of high-profile public statements on fighting HIV we are still waiting for the Government to announce it will put its money where its mouth is.

Enough with the grandiose gestures on HIV, we need action.

Without a smooth transition from the trial to routine commissioning the access thousands of people currently have to PrEP could abruptly end.

This will no doubt cause panic and anxiety for individuals. It will also set us back significantly on a national level too, thereby making the 2030 target nothing but a fanciful dream.

The clock is ticking.

For some it is already too late, with reports of men contracting HIV while waiting for a place on the trial.

These acquisitions were entirely avoidable; is unacceptable that while the drugs are available the appointments needed to access them are not.

This is particularly stark in London where a number of clinics who can provide PrEP have shut their doors to men who have sex with men.

PrEP Impact trial: Man holding a pill used for Pre-Exposure Prophylaxis (PrEP) to prevent HIV infection
PrEP Impact trial: Man holding a pill used for Pre-Exposure Prophylaxis (PrEP) to prevent HIV infection

This impasse must be resolved. No one should be turned away who needs PrEP.

Valuable energies we should be spending setting up innovative, tried and tested methods to increase uptake and awareness among BAME, women, trans, migrants and other groups who could most benefit from PrEP is sucked up navigating a labyrinthian public health system unable to provide access at its most basic level.

Waiting one more year will simply be too late. We cannot even wait a month.

NAT, Terrence Higgins Trust, and PrEPster are today demanding answers and we are calling on the PinkNews community to join us by tweeting Matt Hancock asking when he will deliver on his promise and make PrEP freely available on the NHS. Only our noise can break the silence.

Natasha Dhumma is Head of Policy and Campaigns at NAT (National AIDS Trust).

Follow her on Twitter here. Find more information about NAT here.

The opinions within this article do not necessarily reflect the views of PinkNews.

More: HIV, HIV transmissions, Matthew Hancock, national aids trust, PrEP, Terrence Higgins Trust, UN

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