By Gen Sander

The spread of infectious diseases is a serious problem in prison systems worldwide, with prisoners often many times more likely to be living with Tuberculosis, HIV or hepatitis than a person in the broader community. Alongside the generally poor and unsanitary conditions prevalent in prisons, one major route to infection is unsafe injecting drug use. Yet very few jurisdictions permit or provide harm reduction services (such as clean needles) in prisons. In this blog, Gen Sander, Human Rights Research Analyst at Harm Reduction International, says that states have both a public health duty and a human rights obligation to tackle spread of infectious disease in closed settings.

The spread of infectious diseases affects the population at large, but global data reveal it is an especially acute problem in prison systems worldwide. Tuberculosis (TB) rates, for example, can be up to 81 times higher in prisons than in the general population, while global human immunodeficiency virus (HIV) prevalence is up to 50 times higher among the prison population in some countries. At the same time, one in four detainees worldwide have been found to be living with hepatitis C (HCV), a figure that becomes even more unsettling when compared to, for example, the rate of HCV in the broader community in the WHO Europe region, which is one in every 50.

Prisons represent high-risk environments for the transmission of these diseases for a number of reasons. For one, members of poor and marginalised groups are overrepresented in the prison population worldwide. Many of the factors that make these groups more likely to be incarcerated, including poverty and discrimination, also mean that they tend to carry a disproportionately high burden of disease and ill-health, including higher rates of TB, HIV and HCV.

Punitive approaches to drugs have also led to the mass incarceration of people who use drugs. According to global figures, 10-48% of male and 30-60% of female prisoners are using or dependent on illicit drugs on entry to prison, and every sixth prisoner is thought to be a so-called ‘problem drug user’. In Europe, crimes related to the use, possession or supply of illicit drugs are the main reason for incarceration of between 10% and 25% of all sentenced prisoners.

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Thumbnial: Flickr CC UNICEF