Tech & Rights

As Epidemics Spread, a New Tool for Harm Reduction in Prisons

A new monitoring tool will help improve prison conditions by preventing and fighting the spread of diseases such as HIV and hepatitis C.

by Pauline Couble
Helped by Antigone and six other human rights organizations, Harm Reduction International (HRI), the leading NGO in the field of harm reduction, did an evaluation of the European mechanisms and authorities in charge of monitoring conditions of detention.

These mechanisms, such as the National Preventive Mechanisms (NPM), do exist and do have mandates and expertise to grant detainees' rights, the evaluation concluded, but still do not use given powers to look at the issue in a systematic and comprehensive way.

To improve this monitoring gap, HRI created a new tool based on widely accepted public health and human rights standards. This tool is meant to help monitoring mechanism to produce efficient suitable recommendations and to ensure detainees' human rights, especially in the field of health issued.

The need for better monitoring

This new tool has a double importance: it deals both with a health issue and with a wider human right issue. Epidemics of HIV, hepatitis C (HCV) and tuberculosis are public health emergencies, and they are realities in prisons, where infection rates are far higher than across the rest of society.

For example, 1 in 4 detainees suffers from HCV, while this ratio is 1 in 50 suffers for the total population.

The worrying numbers can be explained by the risky environment inside prisons: vulnerable and disadvantaged groups who are more likely to be infected by HIV, HCV or TB are over incarcerated; drug users are criminalized; prisons are overpopulated; and healthcare and harm reduction services are too often denied to prisoners.

A prisoner appears in the window of Regina Coeli jail in Rome. Roughly 25% of Italian prisoners suffer from hepatitis C. (REUTERS/Dario Pignatelli)

For all these reasons HIV, HCV and TB epidemics are a true health issue in prison - and even outside prison walls, as detainees are in contact with prison staff, visitors and eventually return to their communities.

However, beyond the health issue itself, there is a wider human rights dilemma for states to deal with. Indeed, people do not forfeit their rights when in custody and should have access to the highest attainable standard of health.

European states have a duty to care for people in detention and protect their lives, health and well-being.

Ensuring human rights

The HRI's tool should improve the respect of detainees' human rights by enabling monitoring mechanisms to achieve their mission by formulating more suitable recommendations. An example of this is taking an explicit position on the need of establishing harm reduction services such like needle exchange programs, which have been recommended by the World Health Organization (WHO), the United Nations Office on Drugs and Crime and by the UNAIDS.

The new tool is of primary importance because living conditions in prisons suffer a lack of public attention.

That is why authorities like the NPM and the European Committee for the Prevention of Torture have to be able to produce suitable recommendations and to properly achieve their missions of monitoring and protecting human rights, especially regarding health issues and fatal epidemics. This new tool will help them do so.


Find here the integral report and here the monitoring tool.

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