Title: WHO Health in Prison Project Celebrates 10 Years
Author:
Section/SPIG: Medical Care
Issue Date:
The 33 member States of the WHO Health in Prison Project met in the conference center of the Westminster Church House in London Oct. 17-18, 2005, to celebrate 10 years of accomplishments and discuss the challenges of the next decade. (See AJPH, Oct. 05, 2005, p.1695)
Representatives from the prison medical services of most of the cooperating pan-European nations were in attendance. It was a privilege and a pleasure to observe the deliberations of HIPP that have been central in facing the TB epidemic in Russian facilities, encouraging harm reduction strategies like needle exchange, condoms and opiate replacement and working toward equivalency of care and public health measures between inside and outside of prison.
HIPP brings together prison administrators, public health departments, academics and concerned NGOs to develop penal standards of care and areas of involvement (www.euro.who.int/prisons). National representatives are appointed through the ministers of health. HIPP has developed four consensus statements to date: HIV/AIDS, STD and TB in Prison; Mental Health Promotion; Prison, Drugs and Society; and Promoting Health of Young People in Custody. The Moscow Declaration clarifies that prison health is part of public health, with a resulting European Task Force to facilitate links between prison medicine and public health, to encourage operation within codes of human rights and medical ethics, to promote rehabilitation as the purpose of incarceration, to decrease exposure to communicable disease and to raise the level of medical care to meet community standards.
HIPP is creating a Prison Health Database that will allow online data entry by 2006, and a Prison Health Guide regarding best practice policies and procedures. I delivered the APHA Standards for Health Services in Correctional Institutions (2003) to Lars Moller, the head of the WHO HIPP office, and John Boyington, the director of the HIPP Collaborating Center in London.
During the first day’s Plenary Session, information was presented on the extent of substance abuse in prisons and public health solutions, mental health issues, and the continuing severe problem of TB in Russia and its relationship to incarceration. Nils Christie of the University of Oslo advised that the best way to increase prison health is to decrease the prison population.
The Task Force meeting on the following day included reports from member states. For example, Norway reported about an online course for physicians in prison health available in English (www.lupin-nma.net). Spain described seven years of successful needle exchange in prisons, Portugal discussed their peer education programs, and Rumania their TB control program. Kyrgyzstan has a needle exchange program, and opiate replacement (methadone maintenance) is becoming the standard of care among the HIPP nations. Best practice awards were distributed at an elegant dinner the same evening. Alex Gatherer received a special achievement award for his role in developing HIPP.
I am interested in hearing from anyone in APHA who has contacts in PAHO or among the Pan American nations who would be interested in exploring these issues with our international body. I can be reached at Corey Weinstein, MD, <coreman@igc.org>, 1199 Sanchez Street, San Francisco, CA 94114, (415) 333-8228.