Appeal court ruling on HIV drug victory for common sense, says leading nurse

A high court ruling stating NHS England has the authority to commission a vital drug which could prevent the transmission of HIV has been praised by health professionals and charities.

Three Court of Appeal judges rejected an appeal by NHS England claiming it does not have the legal power to commission pre-exposure prophylaxis (PrEP), because local authorities have the responsibility to arrange preventative services.

NHS England argued that its own responsibilities are limited to treating those who are already infected.

PrEP is a prevention strategy which involves people who are at high risk of HIV infection taking the anti-retroviral drug Truvada to reach optimal levels of protection.

The anticipated cost of providing PrEP services could be up to £20million a year, but could reduce the risk of HIV infection in people at high risk by more than 90%.

Victorious ruling 

RCN public health forum chair and clinical services director at The Sussex Beacon Jason Warriner said: ‘Common sense has prevailed.

‘This means that nurses working in sexual health and HIV services can support people if there is a risk of them getting HIV.

‘The drug is a huge part of the prevention strategy along with things like condoms and testing.

‘Now this decision has been made, NHS England needs to step up and work to provide PrEP.’

The ruling was a victory for charity the National Aids Trust (NAT) with backing from the Local Government Association (LGA).

Three actions 

NAT chief executive Deborah Gold said: ‘HIV is a critical issue in the UK, where more than 4,000 people acquire HIV every year.

‘PrEP works, it saves money, and most importantly it has the power to prevent HIV acquisition for thousands of people, at the same time as beginning to end the HIV epidemic. This judgement brings that possibility one step closer.’

An NHS England spokesperson said: ‘In the light of the court ruling we will therefore now quickly take three actions.

‘First, we will formally consider whether to fund PrEP. Second, we will discuss with local authorities how NHS-funded PreP medication could be administered by the sexual health teams they commission.

‘Third, we will immediately ask the drug manufacturer to reconsider its currently proposed excessively high pricing, and will also explore options for using generics. We expect to be able to update on these developments shortly.’