In a rare, almost unprecedented move, the entire HIV sector has come together to call on the NHS to provide the drug – called Truvada – that stops people contracting the virus.
In a letter to The Times newspaper, every major HIV organisation, along with leading clinicians and prominent activists, have demanded that NHS England seizes the opportunity to radically reduce the number of new infections by making the treatment, called PrEP, available to those most likely to contract HIV.
"The government must now make PrEP available to people at high risk in England," the letter says. "Every day this is delayed, at least seven people will be infected with HIV."
The intervention comes just three days before a critical turning point in the fight for the drug – which is already available in France, Canada, Kenya, Israel and the USA – and what could be a pivotal moment in the history of the virus. On Tuesday, a meeting of NHS England's Specialised Services Committee will take place to decide whether PrEP (which stands for pre-exposure prophylaxis) is NHS England's responsibility and if the organisation can fund it.
It follows a dramatic few months in the course of funding decisions, which began in March when, to the surprise and horror of the HIV sector, NHS England announced that it would not roll out PrEP to all those in need, but instead provide it for just a few hundred men in "test sites", claiming it was not the organisation's responsibility. However, an NHS England document unearthed by BuzzFeed News a few days later contradicted the claim, and the Department of Health admitted to BuzzFeed News that it did not know who was responsible.
But last month, after a considerable outcry and a lengthy legal letter from the National Aids Trust reminding NHS England of its duties, the body backed down and promised to rethink its decision. If on Tuesday the committee gives the go ahead, PrEP will be recommended to the final decision-making stage in a few weeks at the Clinical Priorities Advisory Group.
The full text of the letter in The Times reads:
"A drug now exists that prevents HIV: pre-exposure prophylaxis (PrEP). When taken correctly, it is nearly 100 per cent effective. But NHS England is standing in the way of utilising this remarkable breakthrough. After 18 months of delays, David Cameron has now committed NHS England to giving an answer on PrEP imminently.
"As the decision looms, arguments against PrEP are running out of steam. Men accessing the drug in trials have not shown an increase in sexually transmitted infections. The NHS spends 50 times more on HIV treatment than prevention.
"PrEP, alongside condom use, has enormous potential to reduce HIV transmission. It is available in the US, France and Kenya. The government must now make PrEP available to people at high risk in England. Every day this is delayed, at least seven people will be infected with HIV.
"NHS England will decide on Tuesday if PrEP should be considered for funding. This could be a critical turning point in the fight against HIV — it must not pass us by."
The letter is signed by, among others, the Terence Higgins Trust, the National Aids Trust, the British HIV Association, GMFA, Positively UK, and the European Aids Treatment Group, as well as some of Britain's most eminent HIV doctors, including Professor Sheena McCormack, who conducted the groundbreaking trial into PrEP.
"This could be a critical turning point in the fight against #HIV - it must not pass us by." #PrEP @thetimes
If NHS England's meeting on Tuesday concludes that PrEP should not be made widely available, the organisation could face a battle in the courts.
“We will still be watching and willing to instigate legal action at a later date if we aren’t successful in their reconsideration in May,” Deborah Gold, chief executive of the National Aids Trust, told BuzzFeed News last month. “We’re not walking away from this.”