Australian Access to HIV Preventive Drugs Is Taking Way too Long

On Monday, the Australian Federation of AIDS organisations put out a media release stating "the AIDS public health threat has morphed into an HIV prevention challenge." On the one hand this is a positive announcement because it means HIV infections in Australia rarely progress to AIDS. But on the other, we're still battling HIV, and we're behind progress seen in other countries.

Earlier this year, the Therapeutic Goods Administration (TGA) approved the importation, sale, and use of a drug that essentially works as an HIV preventative. Taken every day this pre-exposure prophylaxis (PrEP) pill, called Truvada, can dramatically reduce a user's risk of contracting HIV. In the US its effectiveness has levered broad social changes within gay community, as we detailed in our 2015 documentary, The Truvada Revolution.

Given PrEP is made up of cocktail of antiviral medications, it's not an HIV vaccine. But for at-risks groups, such as people whose partner is HIV positive, it's incredibly important. Without access, these people will continue to contract HIV at the current historically high rate.

However, there are currently no PrEP drugs listed on the Pharmaceutical Benefits Scheme (PBS). This means, unless you are part of the lucky few who take part in government-run trials of Truvada, you can expect to pay upwards of $10,000 a year for PrEP treatment.

Darryl O'Donnell, CEO of the Australian Federation of AIDS Organisations (AFAO), told VICE this situation needs to change. "Every day [Truvada] is delayed, we are seeing people needlessly acquire HIV," he said. "The government needs to act very, very quickly on any advice from the [Pharmaceutical Benefits Advisory Committee (PBAC)]."

"We're not asking them to take any shortcuts, we just want them to understand that this is life saving."

It's O'Donnell's view that if the PBAC doesn't recommend Truvada for the PBS, the government should press on and negotiate a price with the drug's manufacturer, so it can be subsidised for Australians as soon as possible. If Truvada was more easily available, he says, the HIV infection rate could "drop dramatically."

According to the Kirby Institute there are still more than 1000 recorded HIV infections in Australia each year. That's nearly three people infected every day. The current rate of infection is actually higher than that seen in the late 1980s and early 90s, when the HIV/AIDS epidemic was at its worst in Australia.

In 1989 the Federal Government devised a national strategy to curb with the rise of HIV transmissions. The National Strategy, now in its seventh edition, lists "the virtual elimination of HIV transmission in Australia by 2020" as one of its primary goals. PrEP treatments, such Truvada, are an extremely important part of achieving this.

But when contacted by AFAO before this year's election, only the Greens offered an outright guarantee that they would try to see Truvada listed on the PBS. They also promised a comprehensive action plan to ensure that at-risk communities are supplied with a PrEP treatment option after the Truvada patent expires and a generic option can come onto the market—in the US this could be as early as December 2017.

The Coalition gave a vague promise to "respect the advice of the PBAC." Having declared victory in the election, it remains to be seen what steps the Liberal Party will take to ensure the success of the National HIV Strategy, and the safety of Australia's largely gay, HIV at-risk communities.

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