NHS Commissioning (Pre-Exposure Prophylaxis)

Philip Hollobone Excerpts

Tuesday 7th June 2016 Commons Chamber

[Jane Ellison]

The NHS England position is based on a legal argument, and as the matter is likely to go before the courts, it is not really appropriate for me to comment further. There was a little discussion this morning on this subject in the Health Committee, for which some Members were present. I have laid out a process by which we will work out how and where this is commissioned. Clearly, we need to identify the commissioner.

I do not accept the right hon. Gentleman’s challenge about fragmentation, simply because if we look around the world at a series of very different health systems, we see that they are all going through broadly the same process of understanding where PrEP sits. There are a number of options, but first we need to go through this work. On his latter point about stigma, he is right to identify that it is a significant concern, but I do not accept that that is what this represents. He knows my personal commitment to tackling stigma, and we could not have made it clearer that addressing rising HIV rates, addressing STIs in the MSM community and looking at the challenges surrounding things such as chemsex are all very much front of mind, and we have given considerable time and thought to them. We must challenge stigma wherever it rears its head.

[Mr Philip Hollobone (Kettering) (Con)]

Given the challenges of HIV, I think that my constituents would be excited by the prospects that PrEP offers. They would, however, be a little disturbed by the fact that every country in the world seems to be going through the same process, and duplicating, replicating and holding up what could be a very exciting development to combat the spread of HIV across Africa. Many countries are suffering from this far worse than we are, and they would be horrified by the thought that the process could get bogged down in a court when this treatment, if it were available, could do very real good.

[Jane Ellison]

My hon. Friend is right to recognise that PrEP has potential. It is, in fact, being used in some places internationally. The point I was making was that there is no simple, one-size-fits-all solution. Different countries have different challenges. For example, the level of HIV prevalence and the services available to manage that prevalence, and to manage testing, are very different in different countries. That forms different landscapes into which PrEP might fit. To give an example from Africa, PrEP was licensed last year, and it will be available for sex workers in selected sites. HIV prevalence among female sex workers is estimated to be just under 60% in South Africa. There are different contexts in which PrEP is being taken forward, and that is just one of them.