Two years after a Govenment promise to introduce PrEP for free, the medicine remains unavailable to vulnerable groups who cannot afford it, HIV-awareness NGO Checkpoint Malta has stated.
According to the Centre for Disease Control, PrEP has a 99% efficacy rate in preventing the transmission of HIV from sexual contact, making it a more cost-effective option than life-long treatment for HIV.
Both this HIV pre-exposure deterrant and its counterpart PEP – which is taken after possible exposure to the virus through a high-risk sexual encounter – are viewed as an important tool for curbing rising HIV numbers.
The treatments involve the use of antiretroviral medicines by HIV negative people to reduce the risk of acquiring the virus. Currently, PReP is available at a monthly price of €56.70, making it out of reach for a high percentage of those who need it.
Likewise, PEP is only available locally at a cost of €600 from two pharmacies. The treatment is extremely time-sensitive and needs to be started within 72 hours after exposure for it to be effective. This is further compounded by the fact that a doctor’s prescription from the GU Clinic or A&E (outside of clinic hours).
Both PReP and PEP are primarily intended to protect two of the groups who are most at risk of contracting HIV – MSM (men who have sex with men) and trans persons.
Malta’s rate of HIV transmission remains the highest in the EU, with the numbers increasing steadily year by year. In 2020, 82 people were diagnosed with HIV, translating into a rate of 15.9 per 100,000 people, compared to a European average of just 3.7 per 100,000.
But, earlier this year, a parliamentary question revealed that in 2022 this number went up to 103, (93 men and 10 women, no non-binary people), representing an increase of 25.61%.
Other European countries see a much lower rate of transmission. Amsterdam, for example, though notorious for its party culture, only saw nine people diagnosed according to figures released by Aidsfonds-Soa Aids Nederland. Considering the city counted a population of about 1,166,000 in 2022, these numbers are indicative of the efficacy of providing free preventative treatments.
Most EU countries have seen a decline in transmission rates following the introduction of the free sexual health treatments. Meantime, statistics in Malta continue to climb, Checkpoint Malta stated.
Sexual health experts agree that targeted PrEP programmes, alongside regular HIV testing and the engagement of people with HIV into care and on to suppressive antiretroviral therapy, have led to dramatic falls in new HIV diagnosis rates where they have been rolled out. PrEP is an essential part of combination HIV prevention, reducing long term costs associated with an HIV diagnosis, but also protecting individuals.
Checkpoint Malta is urging the Government to fulfil its promise to introduce both PrEP and PEP on the Government Formulary List, stating that each year sees more new HIV diagnoses which could have been avoided if the medication were to be made freely available.
“This year’s theme for World AIDS Day is Remember and Commit, so we’d like to ‘remind’ the health authorities of their promises and to ‘commit’ to them. How many more avoidable HIV diagnoses is it going to take before this promise is honoured?” representatives of the NGO said, while also reminding that Malta’s long overdue Sexual Health Policy is yet to be released.
NGO’s and stakeholders have yet to be consulted, and in the meantime sexual health on a nation-wide level continues to deteriorate due to poor sexual health awareness, excessive demand for services and lack of resources. The time of words has long passed, and it is now time for action.
Checkpoint Malta’s call was also backed by other NGOs like MGRM, LGBTI+ Gozo, HIV Malta, ARC – Allied Rainbow Communities, Humanists Malta, Doctors for Choice, Drachma, Aditus Foundation, MPSA – Malta Pharmaceutical Students’ Association, Kunsill Nazzjonali Taż-Żgħażagħ, The JAM Project, Moviment Graffiti and the Malta Medical Students’ Association.
