Potentially lethal thinking

Health Minister Terrence Deyalsingh has taken a hard line on Pre-exposure Prophylaxis (PrEp) as a strategy for limiting the transfer of HIV. These drugs act to reduce the possibility of HIV/Aids transfer during intercourse, and the Health Minister's position has been that people should know better than to engage in behaviour that would put them at risk of contracting the virus.

As a member of the Cabinet, it's reasonable to expect that this position on a pivotal health matter is shared through majority consensus by the government itself. But the control of a potentially lethal virus shouldn't be a matter that's governed by the whimsy of politics. It should be managed through measured consideration of established matters of fact. Once the conversation turns to sex between consenting adults, the discussion tends to get bogged down in sticky considerations of choice and risk as if these issues are decided coldly and rationally.

It's surprising to have to point this out to the Health Minister, but people will have sex. They will have risky, ill-considered sex, and as a society, we should consider every method available to reduce that risk.

Diana Roberts contracted the virus from a partner who did not disclose his medical status. This happens. Former health minister Dr Fuad Khan has called for fast-track, subsidised access to PrEp for sex workers, who have sex with multiple, unscreened partners who are unlikely to disclose their medical status. This happens.

It is a fact that there are citizens who are at greater risk for contracting HIV/Aids than others. The PrEp drugs Truvada and Descovy are new to market, and studies are still underway to determine their scope and effectiveness. These are new, expensive drugs which are usually subsidised to reach their intended patients. Costs per person can total more than $50,000 per year. The prescribed medication requires a pill to be taken daily, and early results suggest up to 99 per cent reduction in transmission during intercourse and 74 per cent among injection drug users.

The World Health Organisation has put PrEp drugs on its essential medicines list, not because it wants to encourage risky behaviour, but because the organisation is sensible enough to acknowledge that the threat of transmission exists and that prophylaxis is cheaper than managing the illness. Donna Da Costa Martinez, executive director of the Family Planning Association accused the government of taking a "myopic view" that recasts an HIV control tool as one that encourages promiscuity.

In his tone, Deyalsingh seems to be implying that the Government is taking a moral stance in a critical matter of health, and that's not only inappropriate, it's potentially lethal.