The Health in Prisons Programme HIPP – WHO/Europe’s Network on Prison & Health

1. The Health in Prisons Programme HIPP – WHO/Europe’s Network on Prison & Health Stefan Enggist Technical Officer Prison Health World Health Organization Regional Office for Europe

2. The 53 States of the WHO/EURO-Region Albania, Andorra, Armenia, Austria, Azerbaijan, Belarus, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Georgia, Germany, Greece, Hungary, Iceland, Ireland, Israel, Italy, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Luxembourg, Malta, Monaco, Montenegro, Netherlands, Norway, Poland, Portugal, Republic of Moldova, Romania, Russian Federation, San Marino, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Tajikistan, The former Yugoslav Republic of Macedonia, Turkey, Turkmenistan, Ukraine, United Kingdom of Great Britain and Northern Ireland, Uzbekistan

3. Prison population • Worldwide approximately 10 million people imprisoned • In the WHO/Europe Region approximately 2 million prisoners • Some 6 million people go through prisons of WHO/Europe region per year • Russian Federation approximately 900’000 prisoners • Andorra approximately 80 prisoners • Approximately 5% women

4. Prison population worldwideNumber of prisoners per 100.000 population

5. Prison population in the European Region Number of prisoners per 100.000 populationSource: International Centre for Prison Studies 2011

6. Health in prisons - a matter of Human Rights International Covenant on Economic, Social and Cultural Rights, Article 12: Prisoners are entitled to the highest attainable standard of physical and mental health • UN Standard Minimum Rules for the Treatment of Prisoners • European Prison Rules (Recommendations of the Council of Europe concerning prisons) • European Convention for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (Council of Europe 1987)

7. Principle of equivalence • Health policy in custody should be part of the national health policy; • Health services should be equivalent to those outside prisons; • Medical confidentiality and patient’s informed consent should be guaranteed; • Medical staff should operate in complete professional independence of the prison administration (R (98)/7 Council of Europe) Access to care • Prisoners must have access to a doctor at any time of imprisonment (R (98)/7 Council of Europe) • Sick prisoners who require specialist treatment shall be transferred to specialised institutions or to civil hospitals, when such treatment is not available in prison. (R (98)/7 Council of Europe)

8. Standards of the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) • However, regardless of the difficulties faced at any given time, the act of depriving a person of his liberty always entails a duty of care which calls for effective methods of prevention, screening, and treatment. Compliance with this duty by public authorities is all the more important when it is a question of care required to treat life-threatening diseases. (Committee for the Prevention of Torture CPT Standards rev. 2011) • An inadequate level of health care can lead rapidly to situations falling within the scope of the term "inhuman and degrading treatment“ (CPT Standards rev. 2011)

9. WHO Health in Prisons Programme (HIPP) „…Prisonersarethecommunity. They come fromthecommunity, theyreturn to it. Protection of prisonersisprotection of ourcommunities.“ Joint United Nations Programme on HIV/AIDS (UNAIDS) Statement on HIV/AIDS in Prisons

10. HIPP - aims • To encourage prisons to operate within human rights and medical ethics. • To encourage prison health services to reach standards equivalent to those in the wider community. • To reduce prisoners’ exposure to communicable diseases. • To encourage cooperation between health systems, NGOs and prison health systems.

11. 44 Member States 44 Member States are actively involved: • 18 from Western Europe: • Andorra, Austria, Belgium, Denmark, Finland, France, Greece, Iceland, Ireland, Malta, Netherlands, Norway, Portugal, Spain, Sweden, Switzerland, Turkey, United Kingdom (England, Wales and Scotland) • 16 from Central Europe: • Albania, Bosnia and Herzegovina, Croatia, Czech Republic, Estonia, Hungary, Lithuania, Latvia, FYR Macedonia, Republic of Moldova, Montenegro, Poland, Romania, Serbia, Slovakia, Slovenia, Kosova/UN Admin. Province of Kosovo (observer) • 10 from Eastern Europe: • Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Russian Federation, Tajikistan, Turkmenistan, Ukraine, Uzbekistan

12. International partners • United Nations Office on Drugs and Crime • Pompidou Group, Council of Europe • AIDS Foundation East-West • European Monitoring Centre for Drugs and Drug Addiction • International Centre for Prison Studies, Kings College, London • International Committee of the Red Cross • KNCV Tuberculosis Foundation • Sainsbury Centre for Mental Health, United Kingdom • WHO Collaborating Centre for Promoting Prison Health, Department of Health, England and Wales • American Public Health Association • The Prison Health Expert Group of The Northern Dimension Partnership in Public Health and Social Well-being • International Corrections and Prisons Association

13. Steering Group • AIDS Foundation East-West • Centre for Mental Health • Council of Europe – Pompidou Group • European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) • International Centre for Prison Studies • International Committee of the Red Cross • KNCV Tuberculosis Foundation • The Netherlands • Spain • UNODC • WHO Collaborating centre for Prison Health Department of Health - London

14. Activities WHO HIPP • Annual network meeting – October 10-12 2012: Copenhagen/Denmarkorganized jointly with WHO Collaborating Centre for prison and Health, UNODC and ICRC • Projects in Member States • Best Practice Awards • Publications on prison health topics: • Prevention of acute drug-related mortality in prison populations during the immediate post-release period (2010) • Patient or Prisoner: Does it matter which Government Ministry I responsible for the health of prisoners? (2010) • Health in prisons. A WHO guide to the essentials in prison health (2007)

15. Upcoming in 2012/13 Upcoming 2012 Alcohol and prisoners 2nd edition Upcoming 2013 Stewardship for prison health

17. Contact details: Website: http://www.euro.who.int/prisons Email: stg@euro.who.int Thank you!