UK court overturns refusal to offer PrEP

In a landmark case, the High Court in London has ruled that England’s National Health Service (NHS) acted unlawfully in refusing to offer the HIV prevention drug PrEP.

In March, after 18 months of preparation, NHS England suddenly announced that it would halt its work on the approval and rollout of PrEP, which has shown to be more than 90% effective.

The NHS argued that it did not have the legal authority to offer preventative medication like PrEP to the public. Outraged, the National AIDS Trust (NAT) launched a legal challenge to review the decision.

On Tuesday, the High Court ruled in favour of \NAT and concluded that NHS England’s interpretation of the law was incorrect.

“This is fantastic news. It is vindication for the many people who were let down when NHS England absolved itself of responsibility for PrEP,” commented Deborah Gold, Chief Executive of NAT.

“The judgment has confirmed our view – that it is perfectly lawful for NHS England to commission PrEP. Now NHS England must do just that.”

PrEP is available in England through private doctors but it is expensive for some and NAT believes that it should be provided by the health service.

Gold noted that over 4,000 people are getting HIV every year in the UK and insisted that the delay in providing PrEP is both unethical and expensive.

“We desperately need further prevention options to add to condom use. PrEP works. It saves money and it will make an enormous difference to the lives of men and women across the country who are at risk of acquiring HIV,” said Gold.

NHS England has decided to appeal the ruling, a move that NAT described as “enormously disappointing”.

In the meantime, as a result of the court’s decision, there will now be a 30-day public consultation on PrEP, which should start almost immediately, and an NHS England committee will consider the case for commissioning it.

A final announcement and actual commissioning will, however, be contingent on the outcome of the appeal.

Taken on a daily basis, PrEP (pre-exposure prophylaxis) has been shown to be extremely effective in stopping HIV infection. Its use by gay, bisexual and other men who have sex with men (MSM), especially those at high risk, has been endorsed by the World Health Organisation (WHO).

The South African government recently announced it will provide free PrEP to sex workers and is under pressure to extend this to MSM.