ICRC (press release), Switzerland
March 23 2005
Southern Caucasus: prisoners particularly vulnerable to TB epidemic
Every year, three million people die of tuberculosis (TB).
Prisoners are particularly exposed: they tend to come from society’s
poorest and hence more vulnerable sectors, and prison conditions
foster the spread of the disease.
Through its TB-control programme for prisons in the southern
Caucasus, the ICRC works with the national authorities to help them
meet their objectives, namely to reduce TB morbidity and mortality,
to prevent the development of drug-resistant TB and to curb and
ultimately stop TB transmission within the prison system by
implementing the strategy recommended by the World Health
Organization (WHO).
In Georgia, 3,020 prisoners infected with the disease have received
treatment since the ICRC programme was launched in 1998. In Armenia,
where the programme started in 2002, 270 patients have been treated.
In Azerbaijan, the programme has been running for ten years and
treated 5,500 patients. The programme owes its success to the
involved commitment of the medical staff who work daily to improve
the prisoners’ health.
As a result of the programme’s successful implementation, TB
mortality in prisons in the southern Caucasus has dropped
drastically. In another major achievement, the number of
newly-detected infectious cases has fallen.
This does not mean the problem has been solved, however. The
conditions of detention are difficult: the prisons are often
overcrowded and the prisoners lack light and proper nutrition. What
is more, it is difficult for released prisoners to continue to have
access to treatment. The ICRC is working to facilitate links between
TB services in prisons and outside.
Another major challenge is the high rate of multi-drug resistant
(MDR) TB patients. Improper treatment in the past (treatment
stoppages, incorrect dosage and length of treatment) has lead to the
emergence of MDR-TB, the deadliest form of the disease. The ICRC is
working with the authorities concerned to develop an MDR
case-management strategy in line with international recommendations.
Standards of health care for prisoners should be at least equivalent
to that of the society as a whole. This is why the ICRC is helping
the national authorities to ensure all sick prisoners have access to
proper TB services. What is more, prisons are porous, and the
implementation within their walls of effective TB-control programmes
contributes to effective TB control in the wider community.