Today we join 29 other leading HIV organisations in writing to the Secretary of State for Health and Social Care, Matt Hancock urging immediate action on PrEP.
PrEP stops HIV yet is still not properly available through the NHS. In October the Secretary of State promised to give PrEP a home in England by April 2020.
Our joint letter below:
Dear Secretary of State
RE: Routine Commissioning of PrEP
We wish you warm congratulations on your re-election we look forward to working with you to improve the lives of people affected by HIV. Before the election was called you and the Public Health Minister announced in response to both written and oral questions that the Government is going to implement routine commissioning of PrEP from April 2020. We are writing to you as voluntary sector organisations united in our grave concerns about the provision of PrEP in both the immediate and long term and to ask for your urgent action to ensure we avoid failing the communities it can most benefit. As the government has itself recognised, PrEP is highly effective medication that can prevent the transmission of HIV. Earlier this year the government committed to ending HIV transmissions in England by 2030 and PrEP is a vital tool in achieving this ambitious but achievable target. The government, public sector and voluntary sector are all united in this goal so it is incredibly dispiriting that we find ourselves facing repeated delays in ensuring all those who need PrEP are able to access it.
The PrEP Impact Trial ends in September 2020. To date we have seen no real progress on delivering a funding solution to enable routine commissioning. All stakeholders have agreed that they want to avoid a “cliff edge” in PrEP access but we are concerned that this situation is already upon us. As we write this letter there are currently 36 trial sites across England that are closed to gay and bisexual men. The PrEP Impact Trial’s own calculations project that places will run out in London by early March, six months earlier than planned.
Within the capital, the situation has not improved over the past few months. Since January 2019 no agreement has been made to unlock the remaining 40% of places. Without these London is set to exhaust its allocation imminently.
We now know that at least 15 men have contracted HIV while waiting for a place on the trial. And this is likely to be the tip of the iceberg.
Urgent action must be taken to enable a smooth transition from trial to routine commissioning from April 2020. We understand that it is no longer possible to create further places on the trial to sustain the flow until routine commissioning is in place and the overall pressures on the system substantiate that increased provision cannot continue to be funded at a local level.
In November you announced that you wanted routine commissioning to start from April 2020. We urge you to honor this commitment to ensure all parts of the system are adequately funded and ready to roll out PrEP across England. Routine commissioning also needs to work for all communities that could benefit including women, trans and non-binary, including gender diverse people, BAME communities and gay and bisexual men.
With places on the trial projected to run out before April 2020, we are also calling for an emergency funding solution to power this interim period and ensure that PrEP Trial sites can remain open, can accept additional places in line with local need and continue to serve their local communities.
PrEP works. PrEP saves the NHS money in treatment costs. PrEP will help us end HIV transmissions. We urge you not to renege on your commitment and do what is needed to ensure that this life-changing HIV prevention drug is available to all who could benefit.
We remain committed to working with you to achieve our collective goal of ending HIV transmissions by 2030. We would very much welcome a meeting with you along with NHS England, Public Health England, the Local Government Association and London Councils to see how we can best support and ensure routine commissioning takes place as soon as possible. To schedule a meeting please contact Mark.Lewis@tht.org.uk.
We look forward to hearing from you.
Ian Green - Chief Executive - Terrence Higgins Trust
Deborah Gold - Chief Executive - National AIDS Trust
Will Nutland - Co-Founder - PrEPster
Matthew Hodson - Executive Director - NAM / aidsmap
Ian Howley - Chief Executive - LGBT HERO
John McKernaghan - Chief Officer - The Brunswick Centre
Simon Collins - Co-Founder - HIV i-base
Shaun Watson - Chair - National HIV Nurses Association (NHIVNA)
Michelle Ross - Founder and Director - cliniQ
Rob Cookson – Deputy Chief Executive - LGBT Foundation
Karen Skipper - Chief Executive – Spectra
Rami Ghali- Chief Executive – Brigstowe
Colin Armstead - Joint Interim Executive Director – George House Trust Monty
Moncrieff MBE - Chief Executive – London Friend
Anthony West - Specialist Support Manager - Renaissance UK
Ryan Whittington – Manager - Derbyshire LGBT+
Dr Olwen E Williams OBE - Consultant Physician -Sexual Health / HIV
Tom Doyle - Chief Executive – Yorkshire MESMAC Group of Services
Alex Sparrowhawk – Chair - UK-CAB
Tessa Willow - Chief Executive - Sahir House
Dr Greg Ussher - Chief Executive - METRO Charity
Sophie Strachan - Co Chair - Sophia Forum
Chris Woolls – Director – River House UK
Joanna Melville - External, Press & Acting National Director – Sexpression:UK
Mags Davies – Chief Executive – The Eddystone Trust
Paul Twocock - Chief Executive (Interim) – Stonewall
Dr Laura Waters, - Chair - British HIV Association (BHIVA)
Majella Williams and Roger Hamilton, Co-Chairs of The Bloomsbury Network
Nadia Naous – Chair - HIV Pharmacy Association
Salim Khalifa – Director of Services - Trade Sexual Health