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Fighting for national-level investment in HIV prevention

Kat Smithson

Last week nearly 1500 people wrote to the Minister for Public Health, Jane Ellison, successfully gaining a reversal of the decision to cut the national HIV prevention programme by 50%.

There has been some sort of a national HIV prevention programme since the 90s, but investment in this area has been declining for some time.  Today the national budget for England stands at just £2.45 million a year.  Generally public health is devolved to local authority level.  This means we have widely varied HIV prevention activity across the country and only a small national programme to ensure coverage for those at increased risk.

The current programme, HIV Prevention England, is delivered as part of a three-year contract between the Department of Health and THT.  With the contract due to end in March 2015, we have for some time been concerned about what comes next.  In November 2014 we wrote to the Minister of Health on this very point. 

There is increasing evidence of what does and doesn’t work in HIV prevention.  There is also excellent data on HIV diagnoses, prevalence, transmission networks and those at higher risk – we know that we need a programme that can respond to this evidence and provide much needed strategic focus for HIV prevention – but with no concrete plans with the end of the contract only months away, the opportunity to make this happen appeared to be shrinking. 

By December 2014 our priorities had to change.  On World AIDS Day Earl Howe was pressed on the future of the programme in the House of Lords, and stated that the funding would likely be ‘pared back’. The reason given was ‘funding constraints’.  At an event a week later, Rosemary Gillespie, CEO at THT, confirmed that the cut was to be in the region of 50%. 

Not only were we fighting for a stronger programme from Government, we were suddenly fighting for the current investment to be maintained at all. 

And fight we did.  We moved fast to brief key parliamentarians.  We went out to our activist network providing an opportunity for anyone to voice their concern – and nearly 1500 people did, forcing Government to address the proposed cut to funding.

The case for prevention investment is insurmountable.  In the Minister’s own statement rebuffing the claims that the fund will be cut[1], she said that the Government spent £630 million on HIV treatment and care in 2012/13 alone.  If seven people do not contract HIV as a result of prevention efforts, the national programme has made back the money invested in one year.  And that’s seven people who may be at risk of a long term condition which would significantly impact on their life.  Funding constraints are a reason to invest in prevention. 

This is why the Government has had no choice but to affirm their commitment to the investment – a success for us and all those who campaigned with us.   

This is not the end of the story – we need a strengthened programme and an open, transparent review informing the future beyond 2015/16.  We are looking forward to working with the Government on this, and so are the many other people who care about this issue.

[1] http://www.pinknews.co.uk/2014/12/19/exclusive-government-confirms-it-wi...

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