The Government last week issued its response to the HIV report produced by Lord Fowler’s committee in July (which you can read here). The document, which has been made available in PDF format by the Department of Health, is 31 pages in length and indicates to some extent the current Government’s position on HIV and related issues. Indeed, the Lords report has been largely accepted, and will form the basis of 2012’s new Sexual Health Policy Framework. On the day of the response’s publication, the health minister Anne Milton was quoted as saying:
Twenty-five years have passed since the Government’s first response to HIV and AIDS. At that time there was no effective treatment and an HIV diagnosis was seen as a life-limiting condition resulting in death. Today the availability of highly effective treatment has transformed the outlook for people with HIV.
As the Report makes clear, we need to reduce undiagnosed HIV so people can benefit from effective treatment and to prevent HIV transmission. The Government’s modernisation of the NHS and priority for public health provides a good opportunity to improve outcomes for HIV and improve prevention.
We fully support the emphasis on diagnosis, of course, and are particularly interested in how the Government foresees reforms to the NHS enabling better HIV treatment and prevention. The emphases on funding vaccine research, on working with schools to educate young people, on reducing mother to child transmission, and on a greater focus on primary and community care make a great deal of sense to us. On testing, meanwhile, the response seems to demur from the initial report’s recommendation that “testing should be routinely offered and recommended on an opt-out basis, to newly registering patients in general practice”, and to those in associated secondary care such as TB and hepatitis – though even those recommendations continued to risk missing those not found in either group. Nevertheless, the response concurs that the band on HIV home testing kits should be lifted, and its advocation of wider clinical co-operation and professional development in order to ensure improved diagnosis is welcome. Finally, much seems to rest on the Government’s ultimate analysis of the recent work of several professional bodies:
The Government welcome both the NICE Recommended HIV Testing Guidelines for MSM and Black African Communities and the 2008 British HIV Association (BHIVA) HIV Testing Guidelines. The testing pilot projects funded by the Department of Health in 2009/10 supported implementation and review of the BHIVA HIV Testing Guidelines. In September 2011 the Health Protection Agency published its final Time to Test report reviewing the findings from the pilot projects and other work. The Department will consider the Time to Test report and findings in developing the new Sexual Health Policy Framework. The Department will also ask the UK National Screening Committee to consider all the evidence, including the BHIVA Guidelines, and provide its views on increasing routine HIV testing in high prevalence areas.
We await the Sexual Health Policy Framework with interest.