The World Health Organization (WHO) Global Tuberculosis Programme islaunching a call for case studies and best practices on addressing tuberculosis (TB) in prisons. This includes provision of services for communicable diseases, with a focus on TB prevention and care provided within prisons, as well as on addressing TB in the context of mobility of people between police holding cells, prisons and the community.
An estimated 10.6 million people developed TB in 2022.Despite being preventable and curable, TB remains one of the world’s top infectious killers, accounting for over one million deaths annually. Prisons and other places of detention can be high risk environments for TB transmission due to overcrowding, inadequate infection prevention and control measures, and other determinants such as undernutrition, substance use disorders and inadequate access to health services. The burden of TB disease in prison populations is about 10 times higher than in the general population.In 2019, an estimated 125,105 people in prisons fell ill with TB worldwide, representing about 1% of the global incidence, and only about half of these detected, leaving a large gap of incarcerated people with undiagnosed or unreported TB.
The provision of high-quality health care in prisons, including TB prevention and care, is essential. People in prisons should access health care in the same conditions and of a similar quality as any other person living in the community, throughout their life course. Protecting the human right to health and ensuring universal health coverage are particularly critical in prison settings, where the provision of health services is not always prioritised.
WHO recommendations on TB (prevention, screening, diagnosis, treatment, testing for HIV and comorbidities, treatment support, and infection prevention and control) are applicable to all settings, including prisons. In addition, WHO has specific recommendations on systematic screening for TB disease in prisons and penitentiary institutions, for both prisoners and prison staffas well as systematic testing and treatment for TB infection, which may be considered for people in prisons as well as other at-risk groups including health workers, immigrants from countries with a high TB burden, homeless people and people who use drugs.
WHO has previously issued guidance on the management of TB in prisons, however there have been significant advances in TB prevention and care since this guidance was issued. The WHO Global Tuberculosis Programme is in the process of updating its guidance on TB in prisons. The purpose of the guidance will be to provide operational guidance on the prevention, management and care of TB in prisons, including when people are transferred between police holding cells, prisons and communities. The new WHO guidance on TB in prisons will also feature several case studies illustrating experiences and best practices in addressing TB in prisons.
These case studies may include examples of interventions that are provided within prisons and police holding cells, such as:
· TB screening and active TB case finding for people in prisons as well as prison staff;
· Short course TB preventive treatment and effective management and treatment of TB;
· Screening, diagnosis and care for co-morbidities or other health related risk factors, such as mental health conditions, substance use disorders, HIV, among other conditions;
· Contact investigation, outbreak management and TB infection prevention and control;
· Policies and practices that aim to address the social determinants of TB among people in prisons (such as employment, housing and linkages with social protection services);
· Collaboration between ministries of health and the ministries responsible for prisons and penitentiary institutions;
· Policies and practices on promotion of human rights and the human right to health;
· Building the capacity of prison health staff and inmates to effectively prevent and manage TB;
· Recording and reporting systems on TB in prison settings, and their linkages to the national TB surveillance system, and
· Policies or practices that ensure continuity of care when people with TB are transferred between prisons or from prisons to the community.
Through this call, WHO invites country officials, UN agencies, technical partners, and other governmental and non-governmental stakeholders within and beyond the health sector involved in the provision of health services within prison settings to submit examples of relevant case studies and best practices to this email address:gtbprogramme@who.int.
These case studies and best practices should be no longer than 500 words, should feature current examples implemented in the last ten years and should be structured as follows:
· Background
· Policy or practice implemented
· Results achieved as a result of this policy or practice
· Challenges identified during implementation (and solutions)
· Way forward/ next steps (as a conclusion)
The deadline for submission of case studies and best practices isFriday 30 September, 2024.
All contributors to the selected case studies will be appropriately acknowledged in the WHO guidance on TB in prisons. We thank you in advance for your collaboration, and please do not hesitate to contact us in case of any questions.
