The Irish government has repeated a promise to have a life-changing HIV drug available on the public health service this year.
A review of pre-exposure prophylaxis (PrEP) found that the drug was highly effective at preventing HIV in people at substantial risk. The draft report by the Health Information and Quality Authority (HIQA) backed the use of PrEP alongside frequent monitoring for side effects, testing for HIV and other sexually transmitted diseases, and counselling and advice on safer sex practices. It found that implementing a PrEP programme would be considered cost-saving compared with standard care.
PrEP involves a daily pill of Truvada, which can significantly reduce the chances of being infected when combined with safe sex practices. Trials have found it to reduce HIV in high-risk individuals by about 86 per cent and it has been recommended by the World Health Organisation. The pill is not available through the HSE at present and the named brand version of it can cost €400 a month.
Campaigners have been calling for the introduction of PrEP in Ireland for a number of years as new HIV diagnosis continues to be a major concern across the country.
There were 531 new diagnoses last year, the highest on record, and Ireland stands at almost double the European average at present. The figure is higher than it was during the height of the Aids crisis in the 1980s and 1990s.
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Campaigners have said a lack of urgency from the government is compounding the problem, and have called for better sex education as myths and stigma around HIV present obstacles in the uptake of testing and safe sex.
Leo Varadkar, the taoiseach, and Simon Harris, the health minister, both welcomed the publication of the draft report, and vowed that the drug would be available on the public health service before the end of this year.
“We want to reduce the number of new HIV diagnoses in Ireland. Increasing the availability of PrEP will help us to do so,” Mr Varadkar said. “The introduction of a PrEP programme, coupled with increased testing and greater awareness, will help us to reduce the number of people contracting HIV.”
Mr Harris said the publication of the report was a significant step in the introduction of a PrEP programme in Ireland this year. “Reducing the number of new HIV diagnoses in Ireland is a priority focus for me as minister for health,” he said. “As the report notes, many of the people who would stand to benefit from a PrEP programme are from vulnerable or stigmatised groups in our society, so it is important that we continue to work to reach out and encourage more people to get tested and avail [themselves] of the treatments and supports available.”
The HIQA will now commence a public consultation for five weeks before presenting its final report for the health minister.
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Similar programmes have recently been introduced in a number of other countries. In 2016, NHS England announced funding for a three-year trial of the HIV treatment after a High Court ruled that the health service should consider paying for it.