The NHS in England is on course to become the first country in the world to stop new cases of HIV before 2030, by offering a full armoury of HIV-busting drugs.
Thanks to a series of national deals struck by the NHS, 87,000 people currently being treated for HIV and 61,000 people receiving preventative treatment, will be able to receive the latest HIV drugs, wherever they are in England – with the benefit of improving treatment and reducing transmissions.
This includes the first long-acting injection for HIV, cabotegravir and rilpivirine, which can take the place of daily tablets and with less frequent doses required in eligible patients.
This comes as the NHS this week also approved fostemsavir for multi-drug resistant HIV infections. This the first oral drug to be licensed specifically for people with HIV who have limited treatment options due to tolerance, resistance or safety concerns.
The aim of HIV treatment is to keep the number of virus particles in the blood, known as the viral load, so low that it cannot be detected, meaning it is no longer attacking the immune system.
Those on successful antiretroviral treatments – like fostemsavir – cannot transmit HIV to another person, helping the NHS to become the first healthcare system in the world to reach zero new cases of the virus.
While, highly effective drugs, called pre-exposure prophylaxis (PrEP), can prevent HIV-negative people from getting the virus from people with untreated or undiagnosed HIV.
These trailblazing new national deals will put the NHS in England at the forefront of the fight against the virus.
Professor Sir Stephen Powis, national NHS medical director said: “We now have a genuine chance of achieving no new HIV infections, thanks to the unparalleled efforts of NHS staff and our ability to get effective drugs into the hands of the people who stand to benefit.
“The health service has a proven track record of striking medicines agreements that give patients access to world-leading care at a price that offers the best value for taxpayers.
“This new, national agreement for HIV drugs, along with better testing, diagnosis and support are spearheading the NHS’ fight against the virus by giving more people the treatment they need to stop its spread.”.
HIV is a virus that damages the cells in the immune system and weakens the ability to fight everyday infections and disease, which can result in serious illness and even death, if left untreated.
People who suspect that they have been exposed to HIV within the past 72 hours, can also reduce their risk of getting HIV by taking a treatment called post-exposure prophylaxis (PEP).
Thanks to effective NHS treatment of people with HIV, and better access to preventative drugs PrEP and PEP, transmissions have reduced by 34% between 2014 and 2019.
Blake Dark, NHS commercial medicines director, said: “By providing access to this range of HIV drugs across the country, the NHS will help to prevent thousands of people from contracting HIV and getting seriously ill. It gives us a very real opportunity to be the first nation in the world to reach zero new HIV transmissions by the end of this decade”.
Dr Laura Waters, Consultant Physician, HIV lead Central North West London, Chair of the British HIV Association (BHIVA), said: “Ensuring all people with or at risk of HIV have open and equitable access to the best possible options for treatment and prevention is a crucial step to realising the achievable ambition of zero new HIV transmissions. NHS England has ensured that everyone can be offered the drugs most suitable for them in line with national guidelines from BHIVA and the British Association for Sexual Health and HIV”.
The national commercial agreement for HIV treatment and preventative drugs builds on NHS England’s approach to Hepatitis C elimination, which saw a unique agreement with a number of pharmaceutical companies to make curative hepatitis C drugs available to everyone who needs them on the NHS.
As a result of the world-first deal, there has been a dramatic fall in the number of people living with hepatitis C, which has been cut by nearly 40% since 2015. The NHS has also cut the number of liver transplants needed as a result of hep C by over half since 2015 and reduced hep C related deaths by nearly 40% over the same period. This means the NHS in England is on track to eliminate hepatitis C as a major public health threat in England before the global goal of 2030.
Other far-reaching NHS medicines deals that have transformed patient outcomes include for those with cystic fibrosis, with nine in 10 people with the condition – more than 7,000 people in England – now benefiting from a treatment that tackles the underlying causes of the disease, including the triple therapy, Kaftrio.