We must maintain discussion around HIV prevention and PrEP: Federal Shadow Health Minister

IT’S now been 30 years since panic about AIDS culminated in a three-year-old girl with HIV being driven from her NSW Central Coast pre-school.

Most Australians now know enough about HIV and AIDS to know they are not at risk from a little girl in a playground. If Eve contracted HIV today, her condition would be treated as a chronic disease, not a death sentence and there’s every chance she might never have developed AIDS.

[showads ad=MREC]But as Von, the mother of Theo, says in the HIV Foundation Queensland video HIV Stigma – I have Judged.. other people are going to judge me: “When somebody tells you my sister has got cancer, you go ‘ohhh’ and ‘I’m very sorry about that’. They don’t react in the same way about HIV positive people.”

It’s that stigma which remains the biggest barrier towards meeting the World Aids Day theme of “getting to zero: zero new HIV infections. Zero transmissions. Zero AIDS-related deaths”.

It’s this stigma that the Hawke Government tackled head on with its landmark grim reaper campaign in the 1980s, and helped change the mindset here about how best to protect all Australians from HIV and AIDS. (Editor’s note: there was bipartisan political support for Australia’s response to HIV and AIDS in the 1980s.)

It was Labor that also established Medicare, which, in tandem with the Pharmaceutical Benefits Scheme ensures no one with HIV or AIDS is denied medical care, or the retrovirals which now mean HIV is no longer a death sentence.

However, there is still more, much more we can do.

Whereas just over a decade it was hoped we were on the brink of zero new HIV transmissions, rates then started to rise again and have now levelled off at just over 1000 a year.

While nothing, absolutely nothing will ever take the place of prevention, pre-exposure prophylaxis (PrEP) does offer, in the meantime, the hope of a daily drug that can help prevent the vast majority of new transmissions.

The US Centers for Disease Control and Prevention estimates that daily PrEP can reduce the risk of acquiring HIV from sex by more than 90 per cent and among those who inject drugs by more than 70 per cent.

It was this evidence that drove this year’s ALP National Conference to specifically back the introduction of PrEP in our national platform.

Labor recognises the importance of renewing efforts to reduce the spread of HIV (including adopting prophylactic treatments, subject to the approval of independent regulators and any recommendation from the Pharmaceutical Benefits Advisory Committee), sexually-transmitted infections and blood borne viruses, in partnership with non-government organisations and driven by expert evidence.

In February this year, drug company Gilead began what is expected to be a 12-month process with the Therapeutic Goods Administration (TGA), to license Truvada for use as PrEP in Australia.

Even then it could be months, perhaps years, before the drug can be listed on the subsidised PBS which would make it available for no more than $37.70 per script.

In the meantime, doctors who provide HIV care are allowed to prescribe Truvada as PrEP “off-label” but the cost of doing this from an Australian pharmacy is approximately $10,000 for a year’s supply.

The only other alternative is to purchase a generic version of Truvada from overseas suppliers such as online pharmacies, which is legal, but potentially risky and complicated.

Labor accepts the need for proper processes to ensure Australia’s health system is both safe and secure, but we will be closely watching this process to ensure that should the experts recommend it, the Turnbull Government acts swiftly to ensure PrEP is made available on Australia’s PBS.

Catherine King is the Federal Shadow Minister for Health and the Member for Ballarat.

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