2009 International Conference on Prison Health Protection

29-31 October 2009, Madrid, Spain

The Conference addressed the main health problems related to major communicable diseases in prisons and examined best practices in prison health services. The WHO/Europe Health in Prisons Project (HIPP) organized the Conference was organized in collaboration with the Spanish ministries of Health and Social Policy, the Interior, the Spanish Society for Prison Health (SESP), the “Spanish review of prison health”, the WHO Collaborating Centre for Prison and Health, the United Nations Office on Drugs and Crime (UNODC), European Monitoring Centre for Drugs and Drug Addiction, the “International Journal of Prisoner Health”, AIDS Foundation East–West (AFEW), the Council of Europe’s Pompidou Group, the KNCV Tuberculosis Foundation and the Sainsbury Centre for Mental Health.

Sessions covered:

  • prevention and control of infectious diseases in prison, such as HIV, hepatitis C, tuberculosis, sexually transmitted infections;
  • drug-dependence treatments;
  • harm-reduction methods;
  • the challenges of prison health monitoring and data collection;
  • dual diagnosis issues and complex needs related to drug dependency and mental health;
  • other key areas related to the prevention of infectious diseases in prison, such as through care, planning for the influenza pandemic, prevention of overdose deaths and health promotion.
The Conference was attended by over 300 policy-makers, staff from prisons, criminal justice and health care systems, research workers and academic staff in public health, criminology and clinical care in prisons, psychologists and social workers and nongovernmental organization (NGO) representatives, representing 65 countries worldwide.

Keynote speakers described the status of prison health in Europe and the programme included a wide range of discussions at workshops and round-tables, and the exchange of new ideas and multidisciplinary research findings. Prison visits were organized on the last day.

Madrid recommendation

Participants discussed a set of recommendations to tackle communicable diseases in prisons. The aim of the Madrid recommendation is to ensure that, rather than making matters worse, prisons are a setting where health and health behaviour are improved. The Madrid recommendation recognizes the urgent need in prisons for measures, programmes and guidelines to prevent and control major communicable diseases in prison:

  • alternatives to imprisonment where possible and measures to reduce overcrowding in prisons;
  • counselling, screening and treatment programmes for infectious diseases, including HIV/AIDS, tuberculosis, hepatitis B and C and sexually transmitted infections;
  • treatment programmes for drug users, according to assessed needs, resources and national and international standards;
  • harm-reduction measures, including opioid substitution therapy, needle and syringe exchange, provision of bleach and distribution of condoms;
  • availability of post-exposure prophylaxis and prevention of mother-to-child transmission of HIV;
  • guidelines on the hygiene requirements necessary to manage communicable diseases and other infections and prevent nosocomial infections in prisons;
  • guaranteed throughcare for prisoners upon entry and after release from prison, in close collaboration with stakeholders and local health services;
  • mental health support especially to prisoners suffering from communicable diseases;
  • training of all prison staff on prevention, treatment and control of communicable diseases.

HIPP network meeting

The annual meeting was held before the Conference, on 28 October 2009 to share information and knowledge between WHO and Member States and among Member States.