Creating supportive conditions to reduce infectious diseases in prison populations

Overview

An estimated 11.5 million people are held in prisons globally (1), of whom about 13% are detained in Europe, representing approximately 463 700 people in 2020 (2). Prisons are conducive to the spread of infectious diseases because of environmental factors such as poor ventilation, overcrowding, overrepresentation of vulnerable populations and increased vulnerability due to co-morbid conditions. Prisons can amplify infectious diseases, as people at higher risk for some infectious diseases are incarcerated in environments that have few mechanisms for control. People who live in, work and visit prisons are therefore at higher risk of exposure to infection. Annually, more than 30 million people worldwide move between their communities and prisons. Therefore, if prisons amplify the risk of infection, transmission to the wider community is possible. Failure to take into account such risks, such as in programmes for elimination of hepatitis C or tuberculosis (TB), may undermine disease control for the whole community by transmission from prisons.