NHS Scotland is set to offer the preventative HIV treatment
Scotland will become the first UK jurisdiction to offer preventative HIV treatment on the NHS, with individuals at high risk of infection set to receive treatment within weeks.
The medical case for pre-exposure prophylaxis (PrEP) is irrefutable. It has been shown to reduce risk of transmission by 86 per cent. And although PrEP currently costs £450 a month, it is a far cheaper than treating an already-infected individual — the Terence Higgins Trust estimates the saving at £360,000.
The Telegraph references unnamed ‘health officials’ who apparently ‘previously said that funding the expensive drug could mean children with cystic fibrosis, deaf children in need of hearing implants for hearing loss and amputees needing prosthetics could be denied treatment.’
Of course, every decision made about NHS spending potentially involves opportunity costs. In that PrEP is no different from other treatments.
The Times also cites unspecified sources:
“There has been opposition to Prep’s roll-out on the NHS, with a course costing £450 per month and some critics branding it a ‘lifestyle drug’ that could promote ‘risky’ sexual behaviour. In England, a large-scale clinical trial has been recommended after a series of legal battles over whether the NHS or councils should pay for the treatment.”
Who those critics are, or what motivates them, is unclear. Given that both papers extensively quote representatives of HIV/AIDS advocacy organisations, its strange that — if the treatment really is so controversial — they couldn’t find a single, specific source to quote in opposition to the treatment.
While it’s true that there has been a major legal case over the drug in England and Wales, over the NHS claim that local councils should be responsible for PrEP, that’s reflective of the financial pressures facing the health service overall, not of specific resistance to this treatment.
Thankfully, while the Times and Telegraph attempt to cloak their motivations for questioning PrEP, Ross Clark of the Spectator has no such qualms. The man who previously critiqued that government for trying to make the BBC ‘even more gay’ proudly displays his homophobia to the world.
In an article published yesterday, Clark writes:
“PrEP would be an inappropriate use of taxpayers’ money at the best of times, but coming at a time when the NHS is desperately short of cash it is an outrage that the taxpayer is being called upon to subsidise people to take irresponsible risks: namely having unprotected sex with multiple partners.”
Now, if Clark wants to argue that those who take ‘irresponsible risks’ shouldn’t be supported by the taxpayer, PrEP is a strange place to start. Why not look at blood pressure medication, for example, which is prescribed to thousands of people who take ‘irresponsible risks’ through poor diet or lack of exercise? The cost to the taxpayer is vastly greater than that of PrEP will ever be.
Clark won’t argue that, nor should he. Because while the NHS should and does advocate prevention and responsible decision-making, its ultimate responsibility is to provide care to people who are ill, or at risk of becoming ill.
The reason Clark doesn’t think that maxim should apply here, and the reason the Telegraph and Times think PrEP is ‘controversial’ is that, despite the progress that has been made on LGBT rights, there is an enduring prejudice towards men who have sex with men.
All the evidence supports Scotland’s model of PrEP-provision. England should follow suit, and the right-wing media should put down its dog whistle.
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