A High Court judge has ruled in favour of NHS England funding PrEP (Pre-Exposure Prophylaxis) on 2 August. This means that people at risk of contracting HIV will potentially be able to freely access to a highly effective preventive medicine against the disease.
The case was brought to the Court's attention by the National Aids Trust (NAT) against NHS England. The row between both parties erupted when England's public health body declared it did not have the legal powers to commission PrEP.
NHS England said that local authorities should be the ones responsible for providing HIV prevention services. NAT contested this decision, as it believes that NHS England in fact has the legal powers needed to commission and fund PrEP.
The independent charity also said that most men who have sex with men – who have the highest risk of contracting the virus – use condoms to protect themselves against HIV transmission, but public health services have an 'ethical duty' to provide a preventive treatment for those who do not.
The preventive treatment involves people who are at very high risk for HIV – such as sexually active gay men – taking a combination of two HIV medicines sold under the name Truvada, on a daily basis.
The method has a track record of helping prevent people from contracting the virus via sexual or needle-based contact with somebody who is HIV-positive. Truvada for PrEP provides 92%-99% reduction in HIV risk for HIV-negative individuals who take the pills every day, as instructed.
Studies have shown that PrEP is safe to use with relatively few side effects noted. Other countries have already successfully adopted its use, such as the US and France.
In his judgement, Mr Justice Green wrote: "No one doubts that preventative medicine makes powerful sense. But one governmental body says it has no power to provide the service and the local authorities say that 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."
His decision was welcomed by NAT's chief executive, Deborah Gold who called it "fantastic news".
"It is vindication for the many people who were let down when NHS England absolved itself of responsibility for PrEP. The judgement has confirmed our view - that it is perfectly lawful for NHS England to commission PrEP. Now NHS England must do just that", said Gold.
The ruling should contribute to closing the gap with countries who offer PrEP freely, and make sure vulnerable groups in the UK have access to the best available preventive care. However, NHS England has decided to appeal the judgement, meaning any potential commissioning of PrEP will not take place for months.