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Across Europe, countries face a range of prison-related challenges:

• some facilities currently house up to twice as many prisoners as they were designed for;
• slow legislative processes cause severe bottlenecks at pre-trial detention centres;
• small prisons cannot afford to employ professional health care services; and
• HIV is a constant and growing threat to the prison environment.

Despite their differences, countries can learn from one another, and use experiences gained elsewhere to address their own needs. Introducing polices that are known to be effective can make the difference between creating a supportive environment for this vulnerable group of people or simply warehousing them.

WHO country work
For every biennium, countries decide in which areas they would to like work with the WHO Regional Office for Europe (WHO/Europe) and record the arrangements in biennial collaborative agreements (BCAs).

2008–2009
During the biennium 2008-2009 WHO/Europe worked on prison health issues in Andorra, Croatia and Kyrgyzstan. At the request of the government of Andorra, WHO/Europe assessed the health services provided to prisoners, resulting in a report with specific recommendations. In Croatia the focus was on drug dependence treatment and care and links to the public health system. The activities in Kyrgyzstan focused on substitution treatment and other harm-reduction measures. In 2008 a pilot project on methadone substitution therapy was initiated in a prison hospital and in two pre-trial detention centers. Furthermore, a prison health assessment was carried out.

2010–2011
During the current biennium, WHO/Europe will work on prison health issues with Albania, Kosovo (in accordance with Security Council resolution 1244 (1999)), Kyrgyzstan, the Republic of Moldova, Croatia and Serbia.

Albania
In February 2010 a first mission to Albania took place during which plans were made to increase capacity on drug treatment, including in prisons. This is part of a multi-country drug treatment project supported by WHO/HQ and UNODC.

Kosovo
In May 2010 a first assessment mission to Kosovo took place. A prison health conference was organized with participation of Ministry of Health, Ministry of Justice, the Prison Service and other key stakeholders. Also, prison visits took place and individual meetings with Ministers and Prison Directors were held. Priorities for the biennium were set, which mainly include conducting a detailed assessment of the prison health system in Kosovo and strengthening the stewardship role for prison health.

Kyrgyzstan
During the last years a pilot on methadone substitution therapy took place. A report will be developed and presented in 2011. After this, it is up to the country to decide if this treatment should be expanded to all prisons in Kyrgyzstan.

Republic of Moldova
In March 2010 a first assessment mission to Moldova took place. Meetings were held with main stakeholders in the area of prison and health. A meeting with the Minister of Health took place to discuss the stewardship of prison health. An intergovernmental working group will be established  in 2011 to identify current gaps in the prison health system and to develop an action plan on how to improve the current situation.

Serbia
In February  and November 2010   first assessment missions to Serbia took place. A stakeholders meeting was organized, prisons were visited and meetings with the Ministry of Health, Ministry of Justice and Prison Service were held to discuss priority activities during this biennium. An assessment of women’s health and  the health care  available to them, was conducted in the women prison in Pozarevac. Furthermore, plans have been made to increase capacity on drug treatment in prisons, a project that is supported by WHO HQ and UNODC.