The AHPN welcomes the BBC’s report on the London Specialised Commissioning Group’s controversial move to encourage clinicians to switch patients’ current HIV treatment to a cheaper drug regime.
This commissioning decision is particularly surprising as the government is pushing its “no decision about me without me” policy for greater patient choice. While the AHPN understands the need to save money, this should not be at the expense of the health of people living with HIV.
With promising research results showing that treatment as prevention can dramatically reduce the risk of HIV transmission, it is critical that switching HIV treatment is only done when it is necessary for the benefit of the patient. The AHPN is also concerned that people who are already vulnerable may feel unable to challenge their clinician and might feel they have to accept whatever treatment they are switched on to. This could be considered a drawback to treatment progress made so far and could compromise individuals’ adherence to medication.
"In individual cases, changes to the treatment regimen of the patient should occur only when it is clinically indicated as in the best interests of the patient. Asking doctors to make clinical decisions based on cost places them in an impossible position, caught between the Hippocratic Oath and management diktats. It also risks undermining the trust patients have in their doctors." Jacqueline Stevenson – Community Network Officer - AHPN
The AHPN has been coordinating the Ffena network of over 200 HIV activists and some Ffena members have already experienced the switching of treatment. A member who wished to be anonymous informed that the consultations were inadequate as the presented clinical guidance was not clear and strongly feels that newly-arrived African patients would be less likely to challenge authority figures asking them to switch.”
“While Africans remain one of the largest groups disproportionately affected by HIV, it is not evident as to how many were actually consulted. The lack of a representative voice of those greatly affected by HIV is a drawback to treatment progress made so far and the benefits of adhering to medication, which is a key indicator of well being” Eunice Sinyemu-Head of Policy and Deputy CEO-AHPN.
Even though the costs seem high in the short term, the gains made in secondary prevention could outweigh these costs and thus reduce the numbers of newly acquired transmissions.
Notes
- Doctors criticise London HIV drugs cost-cutting deal. Read more
- Ffena is a network of Africans in the UK living with and affected by HIV. The network enables African people living with HIV in the UK to share their experiences of living with the virus and make their voices heard. Ffena is a Luganda word meaning '[we] all together'. Read more.
- The National African HIV Prevention Programme (NAHIP) coordinates the collaborative action of a network of organisations working across England to contribute to the reduction of the annual incidence of HIV infection. Read more
- AHPN hosts the UK African Microbicides Working Group whose work is to prepare the African community organisations to receive new HIV prevention technologies specifically AIDS vaccines, pre-exposure prophylaxis (PrEP), microbicides, male circumcision, and treatment as prevention.
- For further information please email info@ahpn.org or call 02070178910.