THE BLOG

Scotland Has Made History With Bold Decision On HIV Drug PrEP - But How Long Until The Rest Of The UK Catches Up?

10/04/2017 14:16 BST | Updated 10/04/2017 14:16 BST

Today, Scotland has made history in the fight against HIV.

It has become the first country in the United Kingdom to make HIV prevention drug PrEP routinely available on the NHS.

In one fell swoop, Scotland has leapt ahead of the rest of the UK in terms of its approach to ending the HIV epidemic.

PrEP is a game-changing and stunningly effective HIV prevention treatment. It is taken before exposure to HIV to prevent infection, and has been shown to be nearly 100% effective when taken correctly.

By delivering this treatment on the NHS to those most at risk - and combining it with other vital tools in our HIV prevention armoury, such as condom use, regular testing, and early diagnosis and treatment - this could mark the beginning of the end for HIV transmission in Scotland.

Not only will this make a life-changing difference to each of these individuals by protecting them from a lifelong and stigmatised condition, but for every person who would have become HIV positive without PrEP, the NHS Scotland will save £360,000 in lifetime treatment costs.

This is a trailblazing display of leadership from Scotland that exposes the delays and inaction from the governments in England and Wales in getting PrEP to those most at risk of HIV.

Four months ago, NHS England announced a PrEP trial for 10,000 people over the next three years. We cautiously welcomed the fact that some of those at risk would soon be protected from HIV, but we had a lot of unanswered questions. Who would be able to access this trial? When exactly would it start? And crucially, what would happen to PrEP once the trial was finished? Sadly we still don't have all the answers.

The trial was promised to be coming 'early in the financial year'. However we're now over a week into April. There are big and essential steps that need to be taken before a trial of this size can get off the ground, and there is little evidence that these have happened yet.

We've since heard that the trial will now be coming 'in the summer' - but we need NHS England and Public Health England to be more specific.

For every day that passes without access to PrEP, 17 more people are being diagnosed with HIV. People who accessed PrEP through the PROUD trial are rapidly running out of their supply, and it feels inevitable that some of these people will become HIV positive if the trial is not speedily implemented.

Meanwhile, NHS Wales makes its own decision on PrEP later this month. I have been impressed with the priority the Welsh Minister for Public Health Rebecca Evans AM has given to HIV and sexual health over the past six months. Making it available on the NHS is essential if we are to work towards ending HIV transmission in Wales, so the decision on PrEP will say a lot about the Welsh government's commitment to stopping the epidemic. I hope they will follow Scotland's example in their approach to preventing HIV - not England's.

We've already lost so much time on PrEP and 'later' may be too late for someone who is at high risk of HIV right now. There must be no more delays in England or Wales, and I hope with all my heart that Scotland's bold decision to provide PrEP on the NHS to people who are at risk of HIV will pave the way for more progress across the UK.

We applaud the Scottish Medicines Consortium for acting on the overwhelming evidence for the clinical effectiveness of PrEP, and taking this vital step to tackling HIV in Scotland. We are also grateful to HIV Scotland and the many other organisations and individuals who have tirelessly campaigned and enabled this decision to happen.

Of course, the success of this will lie in the hands of NHS Boards in Scotland. They must now heed the expert advice from the Scottish Medicines Consortium and make PrEP available to their patients who are identified as at risk of HIV, as a matter of urgency.

We must not let protection from HIV become a postcode lottery - either between borders, or within Scotland itself. As we work towards ending this epidemic, no-one in the UK should be left behind.