Last week, the Victorian Government announced an additional $100,000 of funding for the state's PrEPX trial; an attempt to clear a waiting list of over 600 Victorians who are trying to access the drug. The funding comes on top of $1.4 million already directed toward the trial in the state, with over 4,000 people now likely to be able to access the drug.
While the Victorian announcement is welcome, it once again highlights the shambolic national approach to the provision of PrEP. If we are to ever reach the goal of ending HIV, this approach must be replaced with a national strategy that includes the immediate placing of the drug onto the PBS and increased funding for education and access services.
Last year, the Australian Federation of AIDS Organisations declared the 'end of AIDS' in Australia, but HIV infections remain a major issue. There are currently around 1,000 HIV infections every year in Australia, approximately 30% more than just a decade ago. These numbers do not look like they’re changing any time soon.
With these concerning statistics, HIV has once again become a national policy issue. The Australian Government has set out the goal of ending HIV infections by 2020, a proposal backed up by a national HIV advocacy organisation.
It’s a laudable goal, but one that will not be possible unless we fix our national policy regarding PrEP. Considered one of the most effective preventative measures for HIV, PrEP fills a significant gap in the HIV toolkit. It provides avenues for prevention for those who do not want to or are unable to use condoms or other preventative measures, or for situations when these measures fail.
Despite this, Truvada, the brand name of PrEP, was only approved in Australia early last year, four years after the US Food and Drug Administration Approved the same drug. An attempt to list Truvada on the Pharmaceutical Benefits Scheme has been unsuccessful, making the drug extremely expensive for those who want to purchase it in Australia.
This has left those who want to access PrEP with limited options. Unless you want to pay approximately over $1,000 per month to buy the drug locally, access is only available via trials run by State Governments, or through importing the drug from overseas. Both of these present major problems, with trials having limited numbers and reach into the community, and with importation providing logistical and bureaucratic hurdles. Getting the drug is still a difficult, and often tedious, thing to achieve for many.
What we have, therefore, is a patchwork of policies, ones which represent a systematic failure to take the drug seriously. For a Federal Government aiming to end HIV infections in the next three years, this is simply not good enough.
Things need to change, and now.
We need a proper national strategy in relation to the drug – one that brings Federal and State Governments - as well as community organisations – together, in order to best figure out how to make the drug easily accessible to all who want it. We must get rid of the current patchwork of policies we have, making PrEP an integral part of any national strategy to end HIV.
As a first step, PrEP should immediately be placed on the Pharmaceutical Benefits Scheme, a measure that would significantly reduce the cost of the drug. Putting PrEP on the PBS will make it possible to access it cheaply through a GP and/or pharmacist, removing many of the logistical hurdles people face when aiming to get access to it.
Beyond this, the Federal Government must invest in more national funding for education programs and access to PrEP, particularly providing resources for those with a lower-socio economic status. While increased funding for large HIV/AIDS organisations is welcome, part of this must also mean continue to fund local organisations, such as the 2 Spirits Sexual Health Program in Queensland, which is facing cuts to its funding in July. These sorts of programs are essential to equality of access to preventative measures such as PrEP, but cannot do their work if facing the constant threat of funding cuts.
The end of HIV is well within our reach. We could end infections by 2020. We will not, however, be able to achieve this goal if the policy shambles regarding PrEP remain in place. We need a national strategy now, putting PrEP on the PBS and increasing funding for access and education around the drug.