Critical health epidemics are on the rise in prisons internationally. Just this week, new controversy surrounds the issue in the light of breaking news that American prisons may have to invest in expensive drug treatment for inmates infected with Hepatitis C.
The prevalence rate in US jails currently stands at around 17%, in contrast with the general prevalence among the population measuring just 1-2%. With many inmates in the United States alone currently infected with the contagious liver disease, health officials are currently debating the easiest, fastest, and most cost-effective way of treating the epidemic.
Despite the expense of the drug Sovaldi ($7,000 for a 12 week treatment), it may be more cost-effective than other proposed methods of containing the disease. However, the price of the treatment is already raising concerns about the projection for limited usage of the drug across the country.
Sovaldi has the potential to cure inmates currently infected and prevent the spread of the disease in US prisons, but according to SF Gate, no inmates in San Francisco jails are presently being treated with the drug, and only 1 percent of California’s 17,000 inmates infected with the virus have received this specific treatment.
No Isolated Incident
Unfortunately, this most recent outbreak among American inmates is not an isolated incident and reflects more widely upon the state of health epidemics in international prisons.
The World Health Organisation’s Health in Prisons Programme directly aligns imprisonment with infection and points to statistics in Europe as an example: ‘At any given time, over 2 million people are imprisoned in penal institutions in Europe. A prison sentence often entails an increased risk of becoming seriously ill or a lost opportunity to recover from an existing illness or dependency.’
Two of the world’s most considerable prison epidemics are HIV/AIDs and tuberculosis. According to HIV activism organisation and charity AVERT, ‘HIV prevalence within prisons is estimated to be between 2 and 50 times those of general adult populations.’ Reasons for its spread include the high rate of needle-usage in prisons and the increased risk of sex and rape.
In Russia, tuberculosis is particularly prevalent amongst inmates and with time the disease has become increasingly difficult to treat. New strains of tuberculosis are proving to be drug-resistant, and in the high-density prison environment the disease is spreading further and faster over time.
NPR Health reports that ‘prisons were considered to be one of the most dangerous pockets of drug-resistant TB in Russia […]. In 2002, more than 79,000 inmates had active TB infections, and drug-resistant forms were present in about 50 percent of chronic cases.’ With so many recent outbreaks proving drug-resistant, contamination control is becoming increasingly pressurised.
What Is Being Done?
Among those individuals and organisations aiming to combat the state of the prison health system is Dr Paul Farmer, Professor of Global Health and Social Medicine at Harvard University, and founder of The Public Health Institute (PHRI) and Partners In Health (PIH).
Dr Farmer has written extensively on the subject of tuberculosis in Russian prisons in The Global Impact of Drug-Resistant Tuberculosis and his organisations PHRI and PIH have been responsible for the establishment of medical facilities in Russian district prisons to help combat the disease. Dr Farmer’s organisations have been responsible for controlling and treating tuberculosis in Russian prisons since 1997 and the WHO reports that ‘the spread of tuberculosis has been more or less contained over the last three years’.
The treatment of HIV and AIDs seems to be considerably more complex. The AIDs InfoNet reports that ‘25% of HIV-infected Americans’ are jailed each year, of which ‘50% have mental disorders. As many as 75% have alcohol or other substance abuse disorders. These inmates need more than just physical health care.’
The correlation between physical health care and mental health care, then, goes hand-in-hand. Substance abuse, self-harm, and rape culture in prisons are all major contributing factors to the spread of these predominantly blood-transmitted diseases. Along with inadequate funding for the treatment of physical disease in international prisons, there is also the concern that without the proper education and treatment for drug-users, rapists, and self-harmers, the reach of the disease epidemic among inmates cannot be foreseen.
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