ACON CEO: Efforts to lower HIV rates being 鈥渟tymied at a federal level鈥�
Image: (PHOTO: Ann-Marie Calilhanna; Star Observer)
ONE of the country鈥檚 leading LGBTI health advocates has told the Star Observer聽that Australia is 鈥渂ehind the eight ball鈥� when it comes to combating HIV and the Federal Government needed to do more if the goal of zero new infections by 2020 is to be met.
In an exclusive interview to mark World Aids Day, ACON chief executive Nicolas Parkhill said new HIV testing and prevention technologies, such as home testing kits and pre-exposure prophylaxis (PrEP), were unavailable due to being bogged down in federal bureaucracy.
This is despite the Federal Government鈥檚 , launched earlier this year by Health Minister Peter Dutton, stating action needed to be taken 鈥渢o overcome the barriers that impede鈥� efforts to scale up prevention, testing, management, care and support for people living with and at risk of鈥� sexually transmissible infections”.
Parkhill said although ACON was working well with the NSW Government, 鈥渢o secure a reorientation of services for gay men, that ethos gets stymied at a federal level”.
Of particular concern was the slow rate of progress by the Therapeutic Goods Administration (TGA) to approve new drugs and medical devices.
Calling the TGA鈥檚 pace, 鈥渁 significant blockage,鈥� Parkhill noted that HIV home testing kits could be purchased at chemists in the US but were unavailable in Australia.
Meanwhile, only one HIV rapid testing kit 鈥� for use in clinical settings such as ACON鈥檚 a[TEST] centres and the Victorian AIDS聽Council鈥檚 PRONTO! site 鈥� has been given the green light聽by the TGA.
When it came to further rapid testing kits being introduced, Parkhill said: 鈥淭he requirements of TGA approval are probably too high and too expensive.”
鈥淢anufactures are looking at $50,000 to lodge [an application] and not only is it a long process there is no guarantee it will get approved,” he added.
While ACON supported last week鈥檚 announcement by the University of NSW’s聽Kirby Institute of into the real-life experiences of people taking PrEP, Parkhill said the green light should be given much sooner.
鈥淚n other countries we鈥檙e seeing demonstration trials being discontinued because it鈥檚 been proven,” he said.
鈥淲e鈥檙e once again behind the eight ball but what we need is PrEP brought to market so more of the guys who need it get it.鈥�
Parkhill urged聽the Federal Government to partner with manufacturers to spread the cost of new applications and to compel the TGA to fast track approvals for devices and drugs that were already in use overseas.
鈥淕ay men have consistently shown we are strong public health advocates by containing the infection, now the Federal Government needs to meet us more than halfway so we can finish the job,” he said.
The ACON chief said a continuing lack of progress would lead to gay men accessing PrEP and testing kits online.
鈥淭his is a real concern as people bringing in PrEP need to be engaged with healthcare professionals,” Parkhill said.
鈥淲e don鈥檛 want to see a situation where Australia is so slow that effectively you develop an infrastructure that sits below the line 鈥� that would be the worst thing that could happen.”
The Star Observer contacted the Health Minister鈥檚 Office for a response but instead received聽a statement from the TGA.
The spokeswoman said she was confident the 2020 deadline for zero HIV transmission would be met but it was the responsibility of all levels of government to reach that goal.
She added that while the government was keen to minimise red tape and had lifted the ban on home testing kits earlier this year, it was 鈥渘ot the role of government to partner with commercial manufacturers鈥� to bring such a kit to market.
When it came to encouraging or fast tracking approvals, the spokeswoman said: 鈥淣either the TGA, nor the Australian government is able to compel a sponsor to submit an application to have a medication approved through the TGA, or to have a medications indication extended.鈥�
(Main image credit: Ann-Marie Calilhanna; Star Observer)
The Star has portrayed this in a way that gets a political response which is unfair. ACON has had tremendous support from NSW Governments past and present. Canberra has dragged the chain on important reforms for a long time. The bureaucracy seems intransigent
Not surprised, look at the leaders we have.
Note how many liberal MPs wore red ribbons yesterday! The Prime Minister certainly didn’t lead by example. No wonder there are blockages!
Blockages or block heads?
At $800 a month for Prep, it’s not surprising, a similar out come can be achieved with curtailed partner numbers, I don’t see monogamous relationships on ACON’s list of combatting the “epidemic”
Yeah because abstinence works so well in combating these things…
PrEP has the potential to wipe out HIV transmission in one generation…
Could have pointed out condoms but no go for the slut shaming route Mark Bowman, it’s only prejudice & counter to the evidence on STI prevention.
Monogamy doesn’t really deal with rape cases either, or the number of people who aren’t tested so don’t know their status, or the fact that there are monogamous relationships between pos and neg guys.
Cheaper than $4600 a month for anti-retrovirals
What do you expect with “Done Nuttin Dutton” as health minister!
HIV infection rates are actually quite complicated. Over the past 15+ years the number of gay men living with HIV in Australia has grown every year because the drugs have saved people’s lives. Before the treatments, about as many people with HIV used to die each year as were infected. Thankfully, now they continue to live and so the number grows every year. So, if nothing else changed then there would have to be more infections each year. And there has been, but what we’ve actually seen over the past decade is a reduction in the transmission rate. In 2002 the number of new infections was over 6 for every 100 people with HIV, but by 2013 that figure had fallen to just over 4.5. So, given the growth in HIV in the community (due to treatments), the rate of HIV transmission has actually fallen by about 25%. So, it appears individuals may actually be reducing the possibility of infection, even though the raw numbers have increased.
If we want to bring down the actual number of infections, then we need to better understand how infections occur. It seems a disproportionate number of infections are due to guys who don’t realise they have HIV. Getting guys who might be at risk to test much more easily, and taking PrEP before they get infected would be a great development. And yes, PrEP is expensive, because the drug companies take enormous profits while they control the patents. But there are alternatives. Patents eventually expire, and in the meantime there are trials, and generic versions are available online at a fraction of the price (just so long as people make sure they choose a reputable supplier).
Garrett is spot on. We need to ensure we focus on the right measures success. Not simply the number of people diagnosed with HIV. If we focus on the targets that will reduce risk – the numbers of people at risk who are testing frequently, the numbers of undiagnosed infections, the number accessing care or treatment, the number of people reporting protecting themselves and their partners (whether through condoms or negotiated safety) – then the transmission outcomes will take care of themselves.
But we also have to acknowledge that there will always be people unaware of their status, there will always be people who, for whatever reason, engage in risk, and thankfully, there is also a growing number of healthy, socially engaged and sexually active people living with HIV in Australia. This means, for the foreseeable future, there will be HIV risk.
What we need to ensure is that we give people choices to reduce their risk. Allowing home-based testing for those who want it or providing opportunities to access PrEP for people feel this is the best way to protect themselves are just two choices people don’t currently have – unless they go online or happen to be involved in a trial. It really is time the Australian regulatory system caught up with 21st century HIV prevention!
gay men have not consistently shown they are good public health advocates or contained the infection; HIV rates have increased by almost 80 percent in the past decade. People – gay and straight – know the risks of unsafe sex. It is not the responsibility of the government to subsidize the expensive PrEP treatment; it is the responsibility of the individual to be more cautious. For the amount PrEP would cost to subsidize, how many other more important drugs could be put on the PBS where people are sick not because of any decision they made (or didn’t make)?