Last week the US Centre for Disease Control (CDC) issued the first formal guidelines on pre-exposure prophylaxis (PrEP), a promising new way of preventing HIV transmission. PrEP involves people who do not have HIV taking a daily dose of one or two of the drugs that are used to treat HIV. Studies suggest that this can prevent transmission if the user is exposed to HIV.

Last year saw a record number of gay and bisexual men diagnosed with HIV in the UK. 1 in 17 gay men aged 15-59 are now living with HIV, rising to 1 in 8 in London. This compares to 1 in 360 of the UK population as a whole.

Recently-released official statistics show that last year, there were just over 85,000 people accessing HIV treatment and care in the UK. Almost all (91%) of this group were on antiretroviral treatment (ART) and 95% of those on ART had achieved ‘viral suppression’ – this means HIV can no longer be detected in their blood and they can consider themselves ‘non-infectious’.

Part One. Just before the Christmas holidays Public Health England (PHE) released their tender documentation for a new national HIV prevention programme, to last for three years from 2016/17, with the possibility of extensions for a maximum of a further two years.

In my last blog I welcomed PHE’s new tender for a national HIV prevention programme. The annual value of the programme is £1.2 million, the same as the value for HIV Prevention England in 2015/16. In the current context of significant cuts to the public health budget announced by the Chancellor in his Spending Review, to maintain the programme’s value is an achievement, and absolutely necessary given experts agree that HIV incidence is increasing.

Rarely has a u-turn, rarely has a breach of trust, been so misleadingly announced. Reading NHS England’s press release, ‘Update on commissioning and provision of PrEP for HIV prevention’ (21 March 2016), you would think the NHS were simply clarifying progress to date and the well understood responsibilities for the commissioning of PrEP. In fact this press release was the announcement of a shocking U-turn as NHS England suddenly abandoned its own process for the approval of PrEP, just before its conclusion, with nothing to replace it bar some loose change found down the back of the sofa.

In March, NHS England announced it was pulling the plug on an 18 month process to decide whether or not to fund pre-exposure prophylaxis (PrEP) for HIV.

NAT responds to the Government announcement of a NICE Evidence review on PrEP

Some readers will recall the campaign NAT led at the end of 2014 to prevent national HIV prevention spending being cut by 50%. We were successful – and last year in 2015/16 the overall amount spent by central government remained more or less stable at £2.4 million. But what now are the plans for the current year, 2016/17? NAT wrote to Public Health England (PHE) to find out. One thing is clear… not enough is being done in England to prevent HIV transmissions.

In March 2015, Simon Stevens, Chief Executive of NHS England, announced the first national diabetes prevention programme. Reflecting on the potential for the NHS to reduce the future costs of diabetes care by supporting people to lose weight, exercise and eat better, he said that "if these results were from a pill we'd doubtless be popping it