Even though prisoners do not forfeit their human rights, such as the right to health, there is an enormous gap between health and human rights standards and their effective implementation in places of detention. This is in no small part due to the severe lack of harm reduction services for those in detention globally: only seven countries now have a needle and syringe programme, and only 44 provide opioid substitution therapy, in at least one prison.

This report identifies some of the most important human rights and public health standards relating to HIV, HCV and tuberculosis in prisons, and the vital role of harm reduction provision in ensuring them. The report recognises that the right to health and freedom from ill treatment are inseparable, which places human rights-based prison monitors, particularly those with a preventative mandate, in a unique and critical position to consider these issues. It notes, however, that this is not yet occurring in an adequately systematic or comprehensive manner, and provides specific recommendations to the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) and the United Nations Subcommittee on the Prevention of Torture and other Cruel, Inhuman or Degrading Treatment or Punishment (SPT).

Alongside the report, we have created a monitoring tool to assist human rights-based prison monitoring mechanisms and other prison monitors to generate better informed, more consistent and sustained monitoring of issues relating to HIV, HCV, TB and harm reduction in prisons, and ultimately to help prevent situations and conditions that can lead to ill treatment in this context from occurring in the first place.

Both the report and the tool are part of the European Union co-funded project ‘Improving Prison Conditions by Strengthening Infectious Disease Monitoring’ led by Harm Reduction International.