The roll out of PrEP in Scotland signals a vital and long-awaited step towards ending HIV transmission, argues Scottish Hame editor Duncan Hothersall
Campaigners have welcomed the long-awaited decision by the Scottish Medicines Consortium to approve PrEP (pre-exposure prophylaxis) for routine use in NHS Scotland. HIV charities say wider access to the drug could help bring an end to HIV transmission in Scotland.
Taking the small blue pill once a day has been found to reduce the risk of HIV infection by 86 per cent. Up to now PrEP has only been licensed in Scotland for use by people diagnosed with HIV. This new step means it can now be prescribed to those at high risk of infection who do not have the virus.
Scottish Labour leader Kezia Dugdale, who co-convenes Holyrood’s cross-party group on sexual health and blood borne viruses and has long backed the grassroots campaign for wider licensing of PrEP, welcomed the news. She said:
‘This is a historic decision that could lead to a transformational reduction in the number of new HIV transmissions. I applaud all the campaigners who have fought so hard for this for years. It is now vital that the SNP government ensures all NHS boards have the funds required so that PrEP can be made available to those who need it.’
The decision follows years of campaigning by HIV Scotland, Waverley Care, the Terrence Higgins Trust Scotland and the National AIDS Trust. The charities, which campaigned together as the Prep4Scotland Coalition, believe this decision could help to reduce new cases of HIV in Scotland.
The slow pace of decision-making has been a source of frustration to campaigners, and there is clearly relief that wider licensing has now been approved. Robert McKay of Terrence Higgins Trust Scotland said:
‘Today, Scotland has made history in the fight against the HIV epidemic. PrEP can now be used as a vital tool – alongside condom use, regular testing and early treatment – to help bring an end to HIV transmission in Scotland.’
The decision is inevitably leading to questions about HIV prevention strategy in the rest of the United Kingdom. NHS England has long dragged its feet on the issue, claiming that prevention should be the responsibility of local authorities. The court of appeal ruled last year that it was wrong on this score and that NHS England could fund the drug. But in December, rather than a general roll-out across England, a three-year clinical trial was announced.
Campaigners argue that PrEP’s effectiveness as an HIV prevention tool has already been established. The Scottish decision can only strengthen their argument. Ian Howley of GMFA, the gay men’s health charity, said:
‘PrEP is the tool that we have been waiting for and I am delighted that gay and bisexual men in Scotland can now access PrEP free on the NHS. This decision now calls into question why NHS England cannot make PrEP available to all that need it and still insist on a three year trial. We are now calling on NHS England to follow the footsteps of Scotland and provide PrEP to those who are at a higher risk. Every gay and bisexual man living in the entire UK deserves the right to access PrEP for free on the NHS. It’s time this became a reality.’
In Wales, a government-commissioned report last month called the drug ‘highly effective’, and campaigners are awaiting a decision from the All Wales Medicines Strategy Group on its cost-effectiveness. In Northern Ireland, ministers last year made positive noises regarding licensing of the drug, but the collapse of power sharing talks means it is unclear what progress can now be made.
Meanwhile back in Scotland it is a time for celebration. A vital and long-awaited step towards ending HIV transmission is finally a reality.
Duncan Hothersall is a Scottish Labour acivist and editor of Labour Hame. He tweets at @dhothersall
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