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Challenges and achievements
on health in prisons: coordinated actions in response to HIV/AIDS and
co-infections
L. Pittaluga1, A.M. Mello1, D. Gontijo2, F. Nogueira1, J. Campos3, K. Galbinski2, M. Gloria Filho4, N. Santos4, T. Estrela5, X.P. Bermudez6
1Ministry of Health, STD/AIDS and Viral Hepatitis Department, Brasília, Brazil, 2Ministry of Health, Health Prison Coordination, Brasilia, Brazil, 3Ministry of Justice, Penitentiary Department, Brasilia, Brazil, 4UNODC, Health and Development Unit, Brasilia, Brazil, 5Ministry of Health, The National TB Control, Brasilia, Brazil, 6Pan American Health Organization, Family Health Unit, Brasilia, Brazil
Issues: A total of 471.498 people
live under the custody of the Brazilian Penitentiary System. The Ministries of
Justice and Health established in 2003 the National
Policy for Health in the Penitentiary System in order to organize the
access of inmates to public health services. The policy implementation relies
on coordination and networking to be effective, a major challenge for various
involved actors.
Given the confining and overcrowding conditions
of prison settings, the prison population is exposed to health risks factors
such as HIV/AIDS and co-infections.
Description: The Brazilian policy for
health in prisons has been supported by intersectoral actions aimed at joining
political and technical efforts from various programmatic areas of the Ministry
of Health, Health in Prison Coordination, HIV/AIDS, Viral Hepatitis, TB; the
National Penitentiary Authority; UNODC; and PAHO/WHO.
A major result of the
integrated efforts was the Brazilian
Consultation on HIV/AIDS in the Penitentiary System. Among the consultation
outcomes there were the identification of gaps on the policy implementation, the
establishment of recommendations and the consensus of the need to strengthen
intersectoral mechanisms.
Lessons learned: To improve real
conditions of health in prisons throughout the country it is necessary to
develop consistent integrated approach among three government levels, civil
society and international organizations. The consultation was an opportunity to
identify best practices, detect challenges and gaps and enlighten next steps.
Next steps: A training project for
health professionals and prison officers is expected to be implemented in 2010;
the National Policy is under revision; a joint proposal for the 10th
Global Fund on TB and HIV control in prison settings is being developed; an
assessment of health teams working in prisons will be carried out.
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