On May 29, 2017 Portugal as fifth country in Europe announced the introduction of Pre Exposure Prophylaxis (PrEP) as one of the HIV prevention tools covered by the national health system. PrEP, on the individual level, decreases anxiety and increases the level of control and therefore has a positive impact on quality of life. It will also decrease incidence of HIV infections and affect national public health outcomes.
In August of 2016 the European Commission announced the admission of Truvada as PrEP in all 28 EU member states. It’s now on the Member States to ensure access and reimbursement according to their national health care systems. Europe is way behind the USA in accessing PrEP where it has been available since 2012 but now there is a wave of countries opening access to PrEP in Europe too.
Since Truvada is coming off patent in July 2017, more generic options should be expected on the market, the main obstacle, the high price of PrEP may accordingly be reduced. The main caveat is still the price which is relatively high and is not affordable without health insurance The role of NGOs and civil society has been and will be crucial during this time not only in advocating in favour of more prevention options but also empowering communities in accessing PrEP.
For countries where PrEP is not available and in the globalized world we are living in, people will find ways, legally or going around legal barriers (buyers´ clubs), to access PrEP. However, the informal use of PrEP cannot be what national health systems should encourage. PrEP should be implemented as part of the national HIV response, with access to anyone in need. Some countries have already realized this, we can only hope that more countries will follow. The EECA region shows a completely different picture, where access to ARV is still challenging in a lot of countries and PrEP is not on the agenda at all.
Nicholas Feustel made a documentary that explores the stories of over a dozen PrEP activists; current and former PrEP users; clinicians; and policy-makers in UK. The 36 minute documentary film, commissioned by PrEPster, a volunteer group of London-based HIV prevention activists, shines a light on how PrEP has become available to thousands of people, despite the failures of the health system. You can watch the movie here.
