5. Will the Cabinet Secretary make a statement on pre-exposure prophylaxis and HIV prevention? OAQ52753

Thank you for the question. Wales has seen a sustained decrease in new HIV cases. Since I announced the three-year PrEP study, which began in July 2017, 559 people have started on PrEP, and no-one in this cohort has contracted HIV.

Thank you very much indeed for that answer, and further to your oral statement on this issue of 2 October and moving forward, obviously, generic PrEP drugs are cheaper than the current branded ones in issue. Would you agree that if there are any savings to be made from any such future switch to generic PrEP drugs, such savings would be well-used in actively promoting PrEP to groups who are not accessing it in the numbers we might expect at the moment?

You make a completely fair point that once a branded, new medicine is available, there will come a period of time when generic ones are available, and it's work we've actually done across the whole service on making sure that generic products are used in preference wherever possible, because it doesn't remove the value, it improves the value, and it doesn't in any way diminish the efficacy of those drugs.

You make an interesting point about what happens if you see a reduction in a product that is particularly aimed at one area of the service and whether the savings for generic medicine should be retained in that service. What I would say is that I think that we want to make sure we provide equitable access to the best quality treatment, and I would be reticent about taking an approach that might be replicated in other parts of the service that mean we can't mean move funds around where we need to have them, but it would not lessen the importance of making sure we have an effective sexual health service so that we continue on the trajectory of trying to make sure that we meet the World Health Organization's ambition that we become HIV-free at the nearest possible point in the future. 

Can I concur with Dai Lloyd's comments and also welcome the news that the trials appear to have been successful? It seems a long time since those diagnosed with HIV, back when the condition first became known about back in the 1980s, didn't really have any hope. So, the fact that we are now not just having treatment drugs but preventative drugs like this must be welcomed.

From my understanding of the PrEP treatment, it's not just a case of it being taken sporadically, but it has to be taken consistently, and I think with regular medical check-ups every three months to make sure that the effectiveness is being maintained. So, can you tell us, as well as those who have been treated successfully and taken the drugs, what are you doing not only to raise awareness about this type of treatment for those for whom it's suitable, but also to make sure that HIV sufferers who are taking it realise the importance of maintaining that medication so that it's as effective as possible?

Well, look, for those people who have started to take PrEP, we're really encouraged about the fact that no-one who was in that cohort has got HIV since starting. That's really important. But, as I said in my oral statement, we've been looking to get to people with the highest risk, and, so, we found other sexually transmitted infections within that group. That shows we're actually getting to the right sort of people. We've also found people who have had undiagnosed HIV, and they then have been supported in actually receiving appropriate treatment, and that's what we do need to do to make sure people are engaged in services that are built around them, that understand the needs they have to properly support them and people around them to make sure they live the best life possible, because I, too, remember when HIV and AIDS were made widely known—and I was a child—I remember the adverts on tv, and the fear and the stigma that that created. And, actually, to have a message that if you seek support and treatment, then you can live a good life and you can still have a proper life to live, it does not mean that your life is over—the stigma and the fear are still there. So, that is still a job of work for us to do, and I'm genuinely proud that here in Wales we've taken a progressive approach.

I've seen news in your area of the world, with the Argus, this week, printing an article actually talking about the situation in England, where they still have charities wanting a more reputable process than fundraising to provide PrEP to other people. I'm really pleased that I was able to take a decision here in Wales for full nation coverage on an equitable basis, driven by need, and need alone.