Mercedes Gallino Llamas, the Secretary General of Prisons in Spain, opened the session with a dramatic presentation of what prison harm reduction should look like. Spain has drastically reduced HIV and Hepatitis C through comprehensive harm reduction programs that include methadone, buprenorphine and needle exchange. HIV prevalence among prisoners has fallen from more than 20 percent in the 1980s to 7 percent in 2009. Llamas estimates that each year the harm reduction programs are avoiding 200 seroconversions, a result that is saving the prison system 140,000 euros per person in medical and social support costs.

In stark contrast, Albert Zaripov from Russia described bleak conditions in Russian prisons, where he personally experienced needle sharing among 20-30 prisoners and recent cutbacks have eliminated even ARV treatment for many HIV-positive prisoners. In an emotional plea for assistance Zaripov cited recent deaths of AIDS among prisoners and stated  that the HIV epidemic in Russian prisons is getting worse rather than better. Anya Sarang agreed and noted that the root cause of the prison crisis is the criminalisation of even small amounts of drugs in Russia and an utter lack of political will to provide treatment or to protect human rights.

The session provided a short amount of time to discuss strategies for improving access to prevention and treatment in prisons, with ideas from both panel and audience members focusing on the need for continued advocacy.