he health and lives of gay men matter. That’s what the high court ruled on Tuesday morning. Last year, NHS England decided against rolling out a treatment called PrEP – which prevents the transmission of HIV. The wellbeing of gay men was overriden by other priorities. Given it costs substantially more money to treat HIV than to prevent it, even financial considerations weren’t a good reason.
On Tuesday, NHS England was defeated in court and told it was responsible for funding the treatment, and that they have a “preventative role and power to commission preventative function”. Pressure must now be placed on the NHS to start rolling this drug out immediately. As the British Medical Journal pointed out, “delays by NHS England will cost lives”.
If you want to stop HIV spreading, then PrEP is one among many solutions. It works. As studies in the United States have shown, if taken every day, it has been shown to reduce the risk of HIV infection in high-risk individuals by up to 92%. The objections to PrEP, in truth, are based on moral objections. If you do not want the risk of HIV, goes the argument, then wear a condom. Those who get HIV are, by implication, morally condemned for bringing it on themselves.
Of course, safer sex messages must always emphasise the importance of condoms: after all, they protect against many other STIs. But – in the real world, rather than the non-existent world of the morally self-righteous – things are more complicated. People get carried away; people get drunk (yes, in the real world imperfect people sometimes drink more than the recommended daily amount); condoms break. The same moralising is used against the right of women to have control over their own bodies, whether it be the right to abortion or even the morning-after pill. The standards set by the “morally pure” cause harm – or even kill.
We have come so far with the treatment of HIV, once a disease that ravaged the gay world. But according to the Terence Higgins Trust, there are 45,000 men who have sex with men living with HIV; and thousands of them do not know they even have it. The annual rate of newly infected men in 2014 was higher than the decade before. If you genuinely want to send HIV infection rates hurtling into reverse, then PrEP is not the only solution – but it is a good one.
Gay people, their health and their lives, matter. That’s a court judgment. NHS England must now accept the defeat – and start doing its job: protecting health and saving lives.