Thread by @BLUFclub

I'm going to expand on this a little. Note, I don't really want to tell you how to vote, but I do think people should carefully consider the impact of their choices, and issues like PrEP and HIV treatment are very important.

https://twitter.com/BLUFclub/status/1199692590360256514

If you followed the campaigning for access to #PrEP in the UK, you'll remember there were many vocal people against it (even amongst the gay community).

Their argument, essentially, why should the NHS pay for gay men to have unprotected sex.

That's a gross simplification, but it's what many people feel: "they should just use condoms, not expect free drugs," even despite years of "just use a condom" messages clearly not stopping the spread of HIV.
Now, what happens if the cost of PrEP were to go up after a trade deal?

Those arguments would have added forced. And the NHS would be facing higher bills.

There have always been people who have said "why should it pay for self-inflicted things?" The argument has been used about smokers, the overweight, those with drink issues, and others.

"Yes, the NHS is free, but you have to help by keeping yourself healthy" is the argument. It's superficially attractive too.

It's even a sort of policy right now. In some cases, you may not get an operation, eg, unless you lose weight first.

Now imagine a much more cash strapped NHS, with higher drug bills.

It's not much of a leap for a politician to say "Well, we regret we can no longer fund these things in their entirety. If you want PReP, or stuff to stop smoking, or for late onset diabetes, pay 25%"

And that 25% becomes 30%, 50%, and perhaps eventually 100%. And while some complain, the Daily Mail & the Times sternly remind us everyone "must do their bit to help" and who's really going to speak up loudly then for the gays who want to fuck each other?

No one much. That's who

So it's quite possible, if drug patents are an issue in trade talks with the USA, that some of us may find that we can't get PrEP, or some other treatment, free of charge on the NHS.

And while it was available for about £40 a month before, it's likely it would cost much more.

Once we're out of the EU, those £40/month supplies probably won't be available.

The cost to the uninsured in the US can be over $1600 per month.

Even a 10% contribution towards your own costs would make that prohibitive for many people.

Now, it may be that the lapsed European patent on Truvada means it is safe, even with a US trade deal.

But that doesn't mean we won't face exactly this problem with the next gen version of PrEP. Or with some other drug, for some other condition.

This is why generics - out of patent medicines - are so important to the NHS. They help it keep us healthy, at an affordable price.

You don't have to "sell the NHS" to do it hard. You just have to stop it getting drugs at cheaper prices.

You might not need PrEP. But as you get older, chances are you'll need something - like pills for blood pressure, or digestive issues, or something else.

Most of us pay £9 per drug, per prescription. That's a bargain compared to elsewhere, and we should fight to protect.