Aidsfonds clashes with ministry about availability of HIV prevention pill

NOSMinister Ernst Kuipers of Public Health

NOS Nieuws•vandaag, 17:53

Despite the success of the HIV prevention pill to reduce the number of HIV infections, Minister of Health Kuipers sees no possibilities for increasing the availability of the pill this year. This is evident from a letter to Parliament.

The NGO Aidsfonds – Soa Aids Nederland finds this inexplicable, because there are 3,000 people on the waiting list who run a considerable risk of acquiring an HIV infection.

“It is really incomprehensible why a drug that is safe and effective and saves healthcare costs is not used enough,” says Mark Vermeulen, director of the Aidsfonds – Soa Aids Nederland. “PrEP is one of the indispensable tools to definitively stop the spread of the HIV virus. Giving more people access to PrEP brings the end of the HIV epidemic closer.”

Decision this summer

A successful pilot is currently underway in which 8500 people, mainly homosexuals or trans people with many changing sex partners, can receive PrEP via the GGD. This costs them 7.50 euros per month.

Who is PrEP for?

You cannot just get PrEP in the Netherlands. For the time being, only men who have sex with men without a condom are eligible for this pill, or sex workers who have sex with men who have sex with men, or trans people who have unsafe sex with men,

Before a prescription is issued, several tests are carried out to see if someone can handle PrEP, because side effects are possible. Doctors also consider in conversations whether an applicant’s lifestyle necessitates PrEP.

This program will run until August 2024. Minister Kuipers wants to make a decision around the summer whether PrEP will remain available in the Netherlands. In all likelihood that will happen and the drug will become more widely available, but Kuipers wants to wait for RIVM research first. This should clarify how effective PrEP is against HIV infections.

“In addition, RIVM is conducting a scenario exploration into the possibilities of perpetuating PrEP care in a more structural form after the pilot has ended,” says a spokesman for the ministry. “It is important that there is no gap after the pilot has ended.”

Waste of time

Vermeulen considers this state of affairs a risky waste of time. “The effectiveness of PrEP has already been proven with many international studies. The World Health Organization (WHO) has been advising all countries for years to use PrEP in risk groups. And we in the Netherlands are not a separate population group where PrEP would not work. Our own research is not at all necessary to justify expanding the program.”

At the Ministry of Health, Welfare and Sport, they believe that getting rid of the waiting list of 3,000 people is not possible at the moment. “The maximum number of participants in the pilot was increased from 6,500 to 8,500 at the end of 2020,” says the spokesperson.

“There are currently no financial resources to expand the PrEP pilot again. In addition, making more money available would not immediately offer a solution, because the Centers for Sexual Health of the GGD must also have the right capacity and staff.”

Hope for critical parliamentary questions

Vermeulen acknowledges that, as everywhere, there are staff shortages. “But the municipalities of Amsterdam and Utrecht made extra money available last year to increase capacity. That certainly made a difference. Moreover, the large expansion to 8500 turned out well in the end.”

Tomorrow there will be a committee meeting on medical prevention in the House of Representatives. “We hope that MPs will then ask critical questions about the accessibility of PrEP in the Netherlands,” says Vermeulen. “Only the House can still adjust the ministry.”

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