As rates of Hepatitis C in correctional facilities reach levels sixty times that of the general population, it is imperative that the role of needle sharing in the spread of blood-borne communicable diseases is recognised and taken seriously. Some form of Needle and Syringe Program must be implemented to ensure that the duty of care that prison authorities owe to prisoners to protect them from foreseeable harm is fulfilled.
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In 1990, the United Nations adopted the Basic Principles for the Treatment of Prisoners, at its core is the “principle of equivalence” which ascertains that prison health services must be of the same quality and meet the same standards as those of the outside community. As such, as highlighted by the World Health Organisation and the Joint United Nations Program on HIV/AIDS, the higher the rates of injected drug use and associated risk behaviours becomes in prisons, the greater the urgency for the introduction of needle and syringe programs becomes.
The National Drug Strategy approaches drug policy from the position of harm minimalisation, including the reduction of demand, supply and harm. Yet the strategies employed in prisons are highly inconsistent with approaches to illicit drug use in the community. The rates of Hep C infection, transmission and the use of shared needles in correctional facilities also serve to highlight these inconsistencies with rates in the wider community.
Prisoners have highlighted the need for the introduction of a NSP to Justice Action for decades as they would prefer to avoid infection rather than undertake expensive post-infection treatment strategies and should have the right to control their own health care. None of the goals of the NDS or the right to adequate healthcare should be lost because a person is incarcerated.
Many countries have established a variety of carefully controlled programs that allow prisoners who inject drugs to access sterile needles. First established in Switzerland in 1992, NSPs have been established in more than 50 prisons in 12 countries in Europe and Central Asia including:
- Spain
- Portugal
- Germany
- Moldova
- Kyrgyzstan
- Belarus
- Luxemburg
NSPs have also gained great support in Canada and Greece.
