Historic win for NAT as the High Court overturns NHS England refusal to consider PrEP
NAT (National AIDS Trust) is delighted by the judgment passed down in the High Court today that NHS England acted unlawfully in withdrawing PrEP, a game-changing drug preventing transmission of HIV, from its decision-making process.
When, after 18 months of preparation, NHS England suddenly abandoned its work on PrEP, NAT considered it had no option but to challenge this through judicial review. Today the court heard that NHS England’s interpretation of the law was incorrect. PrEP is urgently needed and has been shown to be cost-effective. NAT has always believed that there is no legal impediment to PrEP being commissioned by NHS England and the court agrees.
Deborah Gold, Chief Executive of NAT, said:
“This is fantastic news. It is vindication for the many people who were let down when NHS England absolved itself of responsibility for PrEP. The judgment has confirmed our view - that it is perfectly lawful for NHS England to commission PrEP. Now NHS England must do just that.
Over 4,000 people are getting HIV every year in the UK - we desperately need further prevention options to add to condom use. PrEP works. It saves money and it will make an enormous difference to the lives of men and women across the country who are at risk of acquiring HIV. The delay to commissioning PrEP is both unethical and expensive.”
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.’
He goes on to conclude that in all the possible scenarios that were explored in the judicial review, NHS England does have the power to commission PrEP.
It is enormously disappointing that NHS England has decided to appeal this judgment, especially given the wide ranging and well-reasoned arguments it contains. The appeal will further delay clarity in this area, and mean that any potential commissioning of PrEP will not take place for months. Following this decision, there will now be a 30-day public consultation on PrEP, which should start almost immediately, and an NHS England committee will consider the case for commissioning it, but final announcements and actual commissioning will be contingent on the outcome of the appeal.
Notes to the editor:
NAT (National AIDS Trust) is the UK’s leading charity dedicated to transforming society’s response to HIV. We provide fresh thinking, expertise and practical resources. We champion the rights of people living with HIV and campaign for change.
Shaping attitudes. Challenging injustice. Changing lives.
www.lifewithHIV.org – a resource for HIV positive people
www.HIVaware.org.uk – what everyone should know about HIV
NAT was represented in this case by the following legal team:
Solicitor: Adam Hundt from Deighton Pierce Glynn
Barristers: Karon Monaghan QC from Matrix Chambers and Zoë Leventhal from Landmark Chambers
What is PrEP?
Pre-Exposure Prophylaxis (PrEP) involves HIV negative people taking an antiretroviral drug to avoid getting HIV.
Multiple studies around the world have shown PrEP to be highly effective in reducing the risk of contracting HIV. The results of the PrOUD trial in England, released in 2015, prove that PrEP works and that concerns about it not working in a real world setting, were unfounded. Read more about the trial here: http://www.proud.mrc.ac.uk/
Most trials of PrEP and the US CDC Guidelines involve taking PrEP daily. A study in France, ANRS IPERGAY, has looked at the efficacy of PrEP when taken ‘on demand’, in other words not daily but only before and after sex. There was also significant preventive benefit shown in this trial.