Fully fund councils to avoid stalled roll out of PrEP

The cost of providing the PrEP drug, which could lead to the end of HIV nationwide, needs to be fully funded before its roll out by councils across the country.

That is the view of the Local Government Association, who says that councils’ already overstretched public health budgets - which have been reduced by £700 million in real terms between 2015 and 2020 - will struggle to meet this commitment unless government provides a guarantee to meet any extra and unforeseen costs of providing the drug.

Pre-exposure prophylaxis (PrEP) will be made routinely available from April via local authorities’ public health services, following a successful impact trial. It is recommended for people at high risk and is considered a game-changer in the fight against HIV, by being highly effective in reducing the risk of infection.

The cost will be met by NHS England, but its provision and services related to it will be borne by councils, as part of their existing HIV prevention strategies. Council leaders argue that they will struggle to meet this expectation and is therefore urging for long-term, sustainable funding of the public health services which help people stay healthy and reduce the strain on the NHS and social care.

An estimated 103,800 people were living with HIV in the UK in 2018, with 7,500 of those unaware of their infection. It is estimated that it costs almost £380,000 to treat one person with HIV across their lifetime.

Ian Hudspeth, chairman of the LGA’s Community Wellbeing Board, said: “PrEP is a game-changer in preventing new HIV infections and a vital weapon in our prevention armoury. This is a potentially life-saving drug which can help us achieve the government's ambition of getting us closer to zero transmission by 2030.

“While councils share this ambition and want to see this drug available to everyone who needs it, they will struggle to afford to provide it while their existing public health services continue to be under such strain. Rising demand and increasing attendances at councils’ sexual health clinics, coupled with funding reductions over the last five years, could mean they have little or no capacity left to offer PrEP. Councils want to work with government to ensure that together, with the right resources in place, we meet this shared commitment to eliminating HIV in this country by the end of the decade.”