NHS Again Denies Access to HIV Prevention Drug Because of Bureaucracy

Government control of healthcare gets dangerous when there are entrenched interests.


Credit: Jeffrey Beall

The United Kingdom's National Health Service (NHS) system of socialized medicine is lagging behind the United States in offering a very useful treatment to prevent the spread of HIV, and it's doing so deliberately.

The NHS has announced—or rather reaffirmed—that it will not arrange for the providing of PrEP drug treatments to citizens to help prevent the transmission of HIV.

PrEP is an acronym for a drug cocktail that, when taken regularly, is hugely successful in preventing an HIV-positive person from infecting an HIV-negative person. In the United States it is increasingly being used as a prophylactic drug, especially for gay men who are sexually active but are not using condoms or are in relationships with HIV-positive men. It reduces the risk of HIV transmission to near zero.

In the United Kingdom, these drugs are only prescribed as a post-sex treatment for somebody who believes he has been exposed. Essentially, it's a "Plan B" for unprotected sex in the United Kingdom, even though it can do so much more.

The NHS already announced once it was not going to provide PrEP drugs as a preventative treatment, which prompted huge outrage from activists. NHS officials promised to look over its system to see if it could change the rules. This week they announced they would not, due to possible legal challenges from "proponents of other 'candidate' treatments and interventions that could be displaced by PrEP if NHS England were to commission it." Yes, that's right: These people cannot get these drugs through NHS because it could disrupt some other entrenched treatment provider who would sue.

It is very much an important reminder than under a socialized medicine system, you are no longer the customer. Some very naïve supporters of nationalized healthcare have gotten it into their heads that government-controlled services eliminate corruption and profiteering in the medical system. That couldn't be further from the truth. Nationalized healthcare puts a government stamp of approval on it, as long as the right regulations are followed. This is the actual example that enemies of "big pharma" always point to: the idea that some powerful company would intervene to block treatment because it has a financial stake in the matter. But it's happening because the government controls healthcare.

In America, it's also true that you're really not the "customer" in health care. Increasingly it's your insurance provider. But until the Affordable Care Act came around, we were all free to reject insurance providers that were not covering the services we needed them to. Now we can still technically do so, but we get fined for expressing our right do without.

Here in the states, we can argue whether it's the role of the government to subsidize drugs that exist for the purpose of letting people have sex more safely. But in Great Britain, that's a ship that has fully sailed. The people who are being denied free access coverage to these drugs are nevertheless forced by law to pay into this national system. Then they have to pay out of their own pocket to buy these drugs online. They are not getting the treatment that they are paying for, and on top of that they have to pay extra.

NHS officials did promise to keep working on it to see if there are other ways to improve or increase the distribution of PrEP. An AIDS activist group has said they're considering their own legal action.