Terrence Higgins Trust CEO: ‘Why 2026 must be the year we unlock PrEP through community pharmacies’ (EXCLUSIVE)
"We have the tools, the evidence and the opportunity. Now we need the courage to act," Richard Angell OBE writes for Attitude
A new year is always a moment to take stock: of how far we have come, and of what we must still change.
As we enter 2026, England stands closer than ever to ending new cases of HIV. If we are serious about reaching zero new HIV transmissions by 2030, and being the first country to do it, this must be the year we remove the remaining barriers to HIV prevention.
One of the most powerful tools we have is PrEP, a medication that prevents HIV when taken as prescribed. It is safe, effective and free on the NHS. With over 111,000 PrEP users in England, it is at an all-time high but nowhere near at the levels it should be if everyone is to take charge of their sexual health.
Cracking open access routes to PrEP is the next big challenge
PrEP has already helped drive down new diagnoses, particularly among urban and older gay and bisexual men. But the uncomfortable truth is that take up of PrEP is still unequal, and inequality is now one of the biggest threats to our progress. From (hot) gay farmers to Black women in south London, cracking open access routes to PrEP is the next big challenge.
A new report published by Terrence Higgins Trust, PrEP in Community Pharmacy: Policy options for widening PrEP access in England, sets out the problem and, more importantly, the solution. At present, most people can only access PrEP through sexual health clinics. These services are doing extraordinary work, but they are underfunded, overstretched, and, even if those things weren’t true, there are certain people that will never darken the door of a sexual health clinic.
This might be due to long travel distances – most sexual health services are in large urban areas; limited opening hours – weekend and drop-in clinics are nearly non-existent post-Covid; fear of stigma: or simply not seeing sexual health clinics as a place for them. Coincidentally, women, Black communities, younger LGBT people, queer people of colour and gay and bi men outside major cities remain under-represented among PrEP users. If we do not change how PrEP is delivered, these gaps will persist.
The new year demands new thinking. Community pharmacies offer exactly that.
Pharmacies are at the heart of our communities. They are trusted, local and open for longer hours. People already use them for contraception, vaccines and a growing range of public health services. The report shows that with the right changes, community pharmacists could safely and effectively provide PrEP, widening access while easing pressure on sexual health clinics.
What is holding us back is not evidence, but practicalities
This is not about replacing specialist services. It is about complementing them. By enabling pharmacists to deliver routine PrEP care for people with straightforward needs, clinics would be freed up to focus on complex cases and those who need specialist support. It is a smarter, fairer system.
What is holding us back is not evidence, but practicalities. Current rules around how PrEP medicines are procured and funded make it almost impossible for pharmacies to provide PrEP affordably. The report sets out clear recommendations to fix this – a blueprint for the government fresh of the back its new HIV Action Plan.
At the start of this new year, my message to ministers, NHS leaders and local authorities is simple: let 2026 be the year we unlock PrEP through community pharmacies. The prize is enormous – fewer transmissions, greater equity, and real momentum towards ending HIV transmission in England.
New Years is not about hangovers, but resolutions. Ours is clear. We have the tools, the evidence and the opportunity. Now we need the courage to act.
Richard Angell OBE is chief executive of Terrence Higgins Trust, the UK’s leading HIV and sexual health charity. Appointed in 2023, he previously led its campaigns and policy work, helping secure major government funding for HIV testing and tackle discrimination against people living with HIV.
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