Jane Ellison, Minister for Public Health, announced yesterday that NICE will start looking at the evidence surrounding the clinical effectiveness of pre-exposure prophylaxis for HIV, or PrEP. This is in addition to £2 million being spent on cost-effectiveness studies for PrEP.
The idea behind PrEP is that someone could take medication and prevent themselves from catching the HIV virus when exposed to it, similarly to how people take malaria tablets, and was so effective in placebo controlled trials it was deemed unethical to continue giving a placebo. That same trial found that PrEP was also cost-effective.
I’ve written about PrEP before, achieving my highest accolade in journalism when Dr Christian off the telly retweeted my story. While the decision to have NICE look at effectiveness of PrEP is a positive step forward, it does illustrate the fragmentary nature of sexual health policy in this country. NHS England is looking at cost-effectiveness. NICE looks at clinical effectiveness. Local councils say they can’t afford to fund it if it ever gets approved, NHS England says they have to.
Lacking a central body to coordinate policy on PrEP, the government seems to be floundering on what is a potentially life-saving drug. This floundering will disproportionately affect gay men and other men who have sex with men (MSM).
More happily, the government has agreed to pilot a program of HPV vaccination for MSM thanks in part to the persistent efforts of Mike Freer, officially the MP for Finchley and Golders Green, and unofficially chief parliamentary rabble-rouser for gay and LGBT affairs.
HPV is the sexually-transmitted virus responsible for genital warts and most cervical cancers, and since 2008, a national vaccination program has been in place for girls. HPV is also linked to an increased risk of cancers of the mouth, throat, head, neck, penis and anus, and it doesn’t take the most active imagination to realise MSM might be at higher risks for sexually-transmitted HPV.
The pilot will aim to reach 40,000 MSM in England- around 35% of those who attend sexual health clinics annually. As health is devolved to the national legislatures, Wales, Scotland and Northern Ireland are hoping to develop their own pilot schemes.
Freer has developed a highly effective niche as a backbencher on LGBT and HIV/AIDS issues. He memorably came out to his parliamentary colleagues during a passionate speech on gay marriage.
Random sexual health story – good news comes out of Eastern Europe. Armenia has eliminated mother-to-child transmission of HIV; Moldova, who’ve done the same for syphilis; and Belarus who’ve done the double. These countries may not have made Euro 2016, but they’ve got a much better achievement to celebrate.