The drug regime that prevents people from contracting HIV will be made available in Wales to those at risk, the Welsh government announced on Friday.
Although the full details have yet to be released, a three-year trial broadly similar to what has been planned in England now looks certain, with the medication being given to select individuals vulnerable to infection.
The announcement came as a surprise to campaigners and charities who only 48 hours ago learned that the medication – known as PrEP – had not been recommended by the All Wales Medicines Strategy Group (AWMSG), the body that advises the health service in Wales on the commissioning of drugs.
Its decision not to green-light the pill – brand name Truvada – was seen as a major setback in the fight for access to the drug, just weeks after Scotland had announced a full roll-out.
But Vaughan Gething, the Welsh health secretary, said in a statement: "There is no doubt that Truvada reduces rates of HIV infection when taken correctly and supported by wider, preventative sexual health services can help to reduce overall HIV transmission and infection rates. This is the advice of the World Health Organisation.
“The study that I have announced will mean that all those for whom the drug is clinically appropriate can access it. The study will help us to learn how best to provide the preventative treatment to reduce risks of HIV transmission in Wales and answer some of the questions raised by the All Wales Medicines Strategy Group around incidence rates. I am asking Public Health Wales and the HIV Expert Group to work together to deliver the study.”
Although the study in England is expected to commence later this summer, there is as yet no date for when it will be begin in Wales. But the Terrence Higgins Trust's National Director in Wales, Sarah Fuhrmann, welcomed the news.
“We are heartened and relieved that the Welsh government have listened to people affected by HIV, and will make PrEP available to people who need it in Wales, through a three-year trial," she said.
“Although this is not a long-term solution, it is undoubtedly a momentous step forward for Wales, where investment in HIV prevention has been patchy at best. Making PrEP available to people at risk of HIV will not only protect them from a lifelong and stigmatised condition, it will also save our NHS £360,000 in lifetime treatment costs for every person who would have become HIV positive without PrEP. Common sense has prevailed."
However, Fuhrmann warned that such a trial would only be a "temporary answer".
“We will be looking to the government to commit to making PrEP routinely available in Wales for those at risk, as Scotland has already done. We must not see the same delays or uncertainty that we’ve seen in England around PrEP."
The commissioning of a large-scale three-year trial in England came as a result of a high-profile and protracted court case last year when the National Aids Trust (NAT) took legal action against NHS England for removing PrEP from the standard commissioning route by claiming it was not responsible for HIV prevention.
Responding to the news about PrEP in Wales, Deborah Gold, chief executive at NAT, said: “We’re really pleased that the decision has been taken to make PrEP available to those who need it in Wales. We were extremely disappointed when the All Wales Medicines Strategy Group did not recommend commissioning of PrEP in Wales due to cost-effectiveness concerns."
She added: "The Welsh government has clearly considered the overwhelming evidence in favour of PrEP and the needs of their population in taking this decision - a decision that we think will change the lives of many people in Wales at risk of HIV now and in the future.
"We now need to make sure that this trial is implemented swiftly in Wales so that people who need PrEP can access it sooner rather than later. We wait with bated breath for more of the details on this trial.”