Judge to rule on NHS funding for "game-changing" HIV treatment

A high court judge is to rule on whether a preventive treatment for HIV that charities say is a “game changer” should be funded by the NHS.

Mr Justice Green, sitting in London, has heard a challenge brought by the National Aids Trust (NAT) against NHS England. The case relates to pre-exposure prophylaxis, a “highly effective” antiretroviral treatment protocol used to stop HIV from becoming established in the event of transmission.

Deborah Gold, the chief executive of NAT, told Radio 4’s Today programme that trials in the UK had produced “outstanding” results. “If it’s targeted towards people who are high risk it really does work,” she said.

Gold also defended the use of PrEP against claims that it undermined traditional safe sex messages. “There are lots of reasons why everybody, sometimes with the best will in the world, is not able to consistently use a condom every time,” she said.

“Most people, if they ask themselves honestly, if they or someone they know, if you think about the number of unplanned pregnancies there are, they often happen because with the best of intentions people can’t use a condom every time.

“You think you understand the risk … maybe you make a bad decision, maybe you are a bit drunk, and you make a decision that you wouldn’t make when you were sober. You try to do it every time, but sometimes you slip up, so PrEP is a way for people to be responsible.”

When taken consistently, Truvada, the drug used in the protocol, has been shown to reduce the chance of HIV infection in people who are at high risk by more than 90%.

Earlier this year, NHS England said it would not routinely fund the drug. In March, the body decided the treatment was a preventive service and therefore not its responsibility. NHS England has said local councils are in charge of funding preventive health services.

However, it agreed to a re-evaluation after the NAT launched a legal challenge. Then, on 31 May, the body said it had “considered and accepted NHS England’s external legal advice that it does not have the legal power to commission PrEP,” and that under 2013 regulations, “local authorities are the responsible commissioner for HIV prevention services”.

NHS England said that if it prioritised PrEP there was the risk of a legal challenge from proponents of other “treatments and interventions that could be displaced by PrEP”.

NAT, an independent charity, challenged the decision to exclude PrEP from consideration by NHS England’s clinical priorities advisory group “as part of its annual commissioning process”. The charity argued that the body has the legal power to commission the treatment.

Judge to rule on NHS funding for "game-changing" HIV treatment