PrEP — why the wait?

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05 Nov 2015

It’s safe to say, that when it comes to Truvada’s effectiveness as a preventative measure against HIV, the science is well and truly in: studies from around the world repeatedly find that, when taken daily as a pre-exposure prophylaxis, the little blue pill works as well — if not better — than condoms. So why isn’t PrEP readily available in Australia to those who want it?

Although Truvada’s manufacturer, Gilead, has submitted an application to the Therapeutic Goods Administration for the licensing of the drug as PrEP, there is unlikely to be a response until mid-2016. After that, another interminable wait, as Truvada is considered for Medicare subsidisation — assuming Gilead makes a submission to the Pharmaceutical Benefits Scheme.

At present, people wanting to access Truvada as PrEP in Australia either need to be enrolled in one of the three trials currently underway, pay up to $13,500 per year for an ‘off label’ prescription, or buy a generic online.

For many working in the HIV community sector, providing widespread access to PrEP is a no-brainer and there are growing calls for the licensing process to be fast-tracked. “I really hope the government expedites the response to make PrEP available in Australia,” said Victorian AIDS Council (VAC) CEO Simon Ruth. “Clearly someone has the power; it’s just about figuring out who that person is and putting pressure on them to move this along as fast as we can.”

Indeed, VAC has launched a campaign with that very purpose in mind. As part of the #approvePrEPdownundercampaign, VAC has produced a video which features high-profile members of the HIV community calling for the immediate availability of PrEP. 

“Coming from community leaders with lived experiences as HIV-positive people spanning over three decades, it’s a moving testament to the fact that, had this technology been available, these people would not be living with HIV today,” said VAC CEO Simon Ruth.

Living Positive Victoria is among the many community organisations backing the campaign and its CEO, Brent Allan, is among those featured in the film clip. “This video places people living with HIV where they need to be — championing those strategies which we know make a difference in HIV prevention,” he said.

David Menadue also appears in the video. Menadue believes that PrEP has “an increasingly important role” in HIV prevention. “As the science about its safety becomes even clearer and as society appreciates its value — rather than stigmatising those that use it — [PrEP] will have a profound effect on decreasing the numbers of new diagnoses and helping to end HIV.”

In an article published on Vice.com, Alan Weedon argues that, without PrEP, efforts to eliminate HIV transmissions in Australia will be severely frustrated. “If Australia honestly wants to have no new HIV transmissions by 2020,” wrote Weedon, “widespread access to PrEP may need to come a lot sooner.”

As yet, America is the only country where Truvada is licensed as a pre-exposure prophylaxis — although, following the emphatic findings of the PROUD study, indications are the UK will soon follow suit. In the meantime, Australians most at risk of HIV are being left behind.

BY CHRISTOPHER KELLY