PrEP is the use of anti-HIV medication and stands for pre-exposure prophylaxis. It is an oral tablet taken daily by HIV negative people to prevent HIV contraction. PrEP is different to post-exposure prophylaxis (PEP) which is taken after possible exposure to HIV.
A study published in The New England Journal of Medicine found that participants who regularly took Truvada – the brand used in the trials – had a transmission rate drop of 92% compared to the participants who took a placebo. In other words, PrEP is a highly effective way to reduce exposure to HIV.
PrEP trials have started, or are slated to start, in Queensland, New South Wales, Victoria, Western Australia, and South Australia. But only one brand – Truvada – has so far applied to sell in Australia. Chemist Warehouse sells a thirty-day supply of this drug for $841.69 which puts it out of reach for most.
Truvada is not currently part of the Pharmaceutical Benefits Scheme as a preventative for HIV despite the fact that in May last year the Therapeutic Goods Administration approved the drug.
A push towards a ‘user pays’ system, as well as backward ideas about sex and sexuality hold back access to PrEP and other life-saving medications. Some conservative Christian groups outrageously suggest that HIV is some sort of punishment for gay, bisexual and transgender people. While the major parties would be ridiculed if they openly agreed with this, they are nevertheless keen to not put this constituency offside.
In addition to kowtowing to the conservative Right, there is also a financial motive for the government in not making PrEP more widely accessible. The federal government is already looking to make more cuts to social services as a way of funding tax cuts for corporations. Adding more drugs to the pharmaceutical benefits scheme would run counter to this plan.
While such an argument hasn’t been widely prosecuted here we should be prepared for what has already taken place in the United Kingdom where the right-wing press has described PrEP as a “lifestyle drug” and condemned a High Court ruling that the National Health Service must fund PrEP.
Right-wing commentators have attempted to pit the general public against gay people by saying that funding PrEP will lead to cuts to other services. This is an absolute lie. It isn’t the fault of gay people that budget cuts are being made. There is more than enough wealth being created in society to fund PrEP, as well as all of the other drugs and services we need. The problem is that the wealth is being horded by the richest 1%.
Instead of pretending that we need to rob Peter to pay Paul, the problem could be addressed by closing tax loop holes exploited by the rich and increasing taxes on big businesses. And by removing the profit motive from healthcare altogether, billions of dollars could be freed up for investment.
While PrEP needs to be made accessible to all, it is not a replacement for sex education, needle and syringe programs, and safe sex practices. PrEP is an important tool for minimising HIV contraction and in conjunction with other programs should be freely available in all Australian states. It has the potential to save many lives.
As discussions about PrEP become more widespread in Australia there will be many who will try to use the opportunity to spread homophobic ideas and right-wing economic ideas. Socialists will be at the fore, opposing attempts to pit different groups against each other. We will also argue for an alternative to the shift towards a user pays system and demand free and universally accessible healthcare and medication for all.
By Kai Perry