Must Prisons Remain Dangerous to the Public's Health? November 06, 2007 Dr Lars Moller, PhD Project Manager Health in Prisons Project World Health Organization Distinguished Delegates, Ladies and Gentlemen, I have the pleasure to address the Health in Prisons Project on behalf of WHO. Health in Prisons is an issue of great value for public health and in this presentation I will cover some aspects of relevance for the project especially the epidemiology of HIV/AIDS. Furthermore I will mentioning some of our plans for the coming year.

Purpose of the WHO Health in Prisons Project The purpose of the Project is to support Member States in improving public health by addressing health and health care in prisons, and to facilitate the links between prison health and public health systems both at national and international levels The purpose of the Project is to support Member States in improving public health by addressing health and health care in prisons, and to facilitate the links between prison health and public health systems both at national and international levels

Member States involved 14 from West Europe: Austria, Belgium, Finland, France, Greece, Iceland, Ireland, Malta, Netherlands, Norway, Portugal, Spain, Switzerland, United Kingdom (England, Wales and Scotland 12 from Central Europe: Albania, Croatia, Czech Republic, Estonia, Hungary, Lithuania, Latvia, Moldova, Poland, Romania, Slovakia, Slovenia (observers from Serbia, Kosovo and Montenegro) 9 from East Europe: Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Russian Federation, Tajikistan, Ukraine, Uzbekistan We have not enlarged the network further during the last year but we have today a representative from Azerbaijan: Dr Suleymanov and I hope we will be able to include Azerbaijan in our network later this year.

International Organizations involved American Public Health Association Pompidou Group, Council of Europe AIDS Foundation East-West WHO Collaborating Centre for Promoting Prison Health, Department of Health, England and Wales International Centre for Prison Studies, Kings College, London International Committee of the Red Cross Cranstoun Drug Services European Monitoring Centre for Drugs and Drug Addiction United Nations Office on Drugs and Crime KNCV Tuberculosis Foundation Sainsbury Centre for Mental Health, United Kingdom We have not enlarged the network further during the last year but we have today a representative from Azerbaijan: Dr Suleymanov and I hope we will be able to include Azerbaijan in our network later this year.

Since Romania Steering Group as of May 2007 Representatives: International organizations: Pompidou Group, Council of Europe AIDS Foundation East-West WHO Collaborating Centre for Promoting Prison Health, Department of Health, England and Wales International Centre for Prison Studies, Kings College, London International Committee of the Red Cross Cranstoun Drug Services European Monitoring Centre for Drugs and Drug Addiction United Nations Office on Drugs and Crime KNCV Tuberculosis Foundation Member States: National Agency of Correctional Services, Ministry of Justice, The Netherlands Prison Health Services, Poland Medical Services of the Russian Penitentiary System, Ministry of Justice, The Russian Federation The Task Force had a meeting at the premisis of ICRC in Geneva in May and here is the updated list of Members

Prison population Source: International Centre for Prison Studies

The WHO Health in Prisons Project Actual activities Best Practice award Prison Health Database Guide on prison health Status Paper on Prisons and Tuberculosis Prisons and Mental Health Prisons and Women Country work This year we are mainly focusing on 4 important issues Best practice awards – we have for some years discussed how we could disseminate examples of best practice for our network and other interested in this subject. Our Collaborating Centre has been very active in this process and last year we awarded 15 prisons in Europe and we will give out the next awards next year. We have established a database with the examples. Talking about databases – we have developed a prison health database – we do this work in collaboration with the European Monitoring Centre for Drugs and Drug Addiction and the European Network on Drugs and Infections Prevention in Prison and we have received funding from the European Commission to support the development. Still we are collecting data but we have developed a tool for data presentation and data are available through our website. Currently, we are performing the final editing of a prison health guide, covering the most important area of prison health. The guide will be a new tool for prison health personnel. We expect to have a printed version ready by February 2007. In October we organized a conference on prisons and TB and a draft status paper on tuberculosis was adopted. The paper will be published early in 2007 and will give eveidence based recommendations on TB in prisons.

Drug users in two prisons of Kyrgyzstan n=977 been more than 3 months in survey prisons 79% used drugs during last 3 months 55% used Marihuana 72% used Heroin 64% used Opium 73% injected during last 3 months 18% shared needles/syringes during last 3 months 37% had their first drug experience in a prison

Country work Example: Kyrgyzstan Demonstration project Renovation of facilities Training of prisoners and staff Needle exchange programmes Closed prisons Open prisons Methadone substitution therapy Public system Prisons and remand facilities Study tour Clinical protocol Working group evaluation Evaluation of prison health system Collaboration with ICRC Clinical protocol's on prison health issues (MST, HIV)

Web site: http//:www.euro.who.int/prisons lmo@euro.who.int Contact Lars Moller: lmo@euro.who.int