A leading Aids charity has won a high court battle over whether a preventative treatment for HIV that charities say is a “game-changer” can legally be funded by the NHS.
NHS England said it had received advice that it did not have the legal power to fund pre-exposure prophylaxis (PrEP), a “highly effective” anti-retroviral treatment used to stop HIV from becoming established in the event of transmission.
But Mr Justice Green, sitting in London, ruled that NHS England “has erred in deciding that it has no power or duty to commission the preventative drugs in issue”.
The ruling was a victory for the National Aids Trust (NAT), which brought the case to court.
Deborah Gold, the NAT chief executive, said: “This is fantastic news. It is vindication for the many people who were let down when NHS England absolved itself of responsibility for PrEP. The judgment has confirmed our view that it is perfectly lawful for NHS England to commission PrEP. Now NHS England must do just that.
“Over 4,000 people are getting HIV every year in the UK – 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. The delay to commissioning PrEP is both unethical and expensive.”
When taken consistently, PrEP has been shown to reduce the risk of HIV infection in people who are at high risk by more than 90%.
Related: Hope for ‘end of Aids’ is disappearing, experts warn
A row erupted earlier this year after NHS England said it would not routinely fund the drug. In March, the body decided the treatment was a preventative service and was therefore not its responsibility. It has said local councils are in charge of funding preventative health services.
However, NHS England agreed to a re-evaluation after the NAT launched a legal challenge. Then in May it 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”.
Allowing NAT’s application for judicial review, Green said on Tuesday the core of the legal challenge was about “the allocation of budgetary responsibility in the health field”.
He said: “No one doubts that preventative medicine makes powerful sense. But one governmental body says it has no power to provide the service and local authorities say they have no money.
“The claimant is caught between the two and the potential victims of this disagreement are those who will contract HIV/Aids but who would not were the preventative policy to be fully implemented.
“In my judgment the answer to this conundrum is that NHS England has erred in deciding that it has no power to commission the preventative drugs in issue.”
Alternatively, said the judge, NHS England has “mischaracterised the PrEP treatment as preventative when in law it is capable of amounting to treatment for a person with infection”.
In any event NHS England had power to commission preventative treatments because that facilitated, or was incidental to, “the discharge of its broader statutory functions”.
Campaigners have said that while the majority of gay men use condoms to prevent being infected with HIV, there is also an “ethical duty” to provide PrEP to those who do not.
And they said the drug would provide an additional defence against HIV – and would not be used simply as an alternative to safe sex.
It comes after the results of a trial, published in February 2015, suggested that rates of HIV infection could be slashed by treating actively gay men with the anti-viral drug when they are healthy.
Dr Michael Brady, medical director at the HIV/Aids charity Terrence Higgins Trust, welcomed the findings and described the drug as “a game-changer”.
He said PrEP offered “another line of defence” against HIV, alongside condoms and regular testing. Brady said: “It is not a vaccine and it won’t be for everyone, but, once approved, we expect it to significantly increase the momentum in our fight against the virus.
“We urge the government, NHS England and local authorities to make PrEP a key priority in the fight against HIV.”
NHS can fund "game-changing" PrEP HIV drug, court says
Hiç yorum yok:
Yorum Gönder