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HIV treatment decision will ‘heap more pressure’ on public health – LGA

The NHS refusal to overturn a decision to stop funding HIV prevention medication will “heap more pressure” on public health services by transferring the cost to them, the LGA has said.

The NHS had agreed to review the decision to stop commissioning the drug PrEP, following a legal challenge from the National Aids Trust (NAT).

However, it had received independent legal advice saying it did not have the power to commission the drug because it overlaps with the legal duty of local authorities to provide services for sexual infection prevention.

Cllr Izzi Seccombe, the LGA’s community and wellbeing spokesperson, said: “This is hugely disappointing and a missed opportunity to launch a ground-breaking method of treatment which could halt the spread of HIV and potentially save lives.”

“Councils have invested millions in providing sexual health services since taking over responsibility for public health three years ago, and the PrEP treatment could help reduce levels of HIV in the community.

“During the transition period to the implementation of the NHS and Care Act 2010, NHS England sought to retain commissioning of HIV therapeutics, which the PrEP treatment clearly falls into.  It is, and should remain, an NHS responsibility unless it is fully funded for local authorities to pass on.

“Councils are already having to manage significant funding reductions to their public health budgets of £500m over five years and NHS England's decision not to commission PrEP will only heap more pressure on public health services."

Deborah Gold, chief executive of NAT, said: “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.

“Seventeen people are being diagnosed with HIV every day. We are extremely disappointed and we will now be looking at our options, including further legal action.”

The NHS said that, regardless of the legal advice, there was “no guarantee” that it would be able to fund PrEP, due to the competition between different services and treatments for funding.

It added that it would commit £2m over the next two years to a joint venture with Public Health England to research the most efficient ways of commissioning PrEP in pilot areas.

Public Health England has also announced a £600,000 grant for third sector HIV prevention initiatives.

Ian Green, chief executive of the Terrence Higgins Trust, which is also campaigning against council cuts to HIV support services, said: “This is a shameful day for HIV prevention. This country used to lead the way in the fight against the HIV epidemic, but today, our national health service has washed its hands of one of the most stunning breakthroughs we’ve seen; a pill which, if taken correctly, is almost 100% effective in preventing HIV.

“How did it come to this? It defies belief that, after 18 months of false hope, delays and U-turns in the battle to see PrEP made available on the NHS to people at high risk of HIV, today we are in a worse position than when we started.”

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