Ending tuberculosis everywhere means EVERYWHERE
Tuberculosis (TB) remains a global health threat, and an urgent focus on prison settings is necessary.
Findings from the EUSAT-RCS TB research consortium, presented at the "Prison TB Alliance Meeting" in Asuncion, Paraguay, reveal a sky-high prevalence of TB in Latin American prisons, particularly in Paraguay, where the risk of developing TB is over 100 times higher than in the general population.
Why does TB in prisons matter for everyone?
Prisons are not islands and are certainly not isolated from society. The high rates of TB among people in prison settings drive up TB incidence in the general population, making it clear that “no one is safe until everyone is safe.” The health of people deprived of liberty is a public health concern that affects us all.
Overcrowding, limited or inadequate access to healthcare, and rising incarceration rates have created a “perfect storm" for TB transmission, threatening people deprived of liberty, family members, staff, and the broader community.
Extract from the White Paper Call for Action from the "Alliance Meeting" with statements from PriNose study participants
A Health in All Policies (HiAP) approach to ending TB
Health is a fundamental human right. All people deprived of liberty have the right to equitable access to prevention, testing, treatment and care. Addressing TB in prisons requires more than medical interventions. It calls for a Health in All Policies (HiAP) approach, one that brings together ministries of health and justice, policymakers, prison authorities, and communities.
The White Paper Call for action from the “Prison TB Alliance Meeting” outlines recommendations to tackle the TB burden in prison settings in Paraguay, and includes:
- Improving access to healthcare and TB screening in prisons.
- Investing in health education for inmates and staff.
- Reforming penal codes to reduce overcrowding and promote alternatives to incarceration.
- Ensuring adequate living conditions, including proper ventilation and hygiene.
A rights-based approach also ensures that TB care is not only effective but also just and humane. Raising awareness about human rights among people deprived of liberty and staff enhances access to care and reduces stigma.
KNCV expert, Jerod Scholten, participated in the “Alliance Meeting” in 2024 and has been involved in the continued development of the White Paper and calls for investing in research and development are imperative to avert a potential TB catastrophe in Paraguay. In his words,
A multi-disciplinary approach is needed to stop this epidemic of TB in prisons in Paraguay and elsewhere in Latin America. TB is preventable and treatable but if not handled properly causes immeasurable human suffering. We have tools available to stop this based on evidence and experience-let’s not wait any longer because inaction creates a ticking time bomb. A multi-sectoral approach is needed to address this tragic situation including, but not limited to, engagement of experts in TB prevention and care, infection prevention and control, TB diagnostics as well as treatment for comorbidities; engagement of government authorities, prison staff, international bodies and donors, communities, loved ones of people who developed TB in the prisons and the people deprived of liberty themselves.
The time to act is now!
As the White Paper claims, the time to act is now. Implementing WHO screening algorithms, providing preventive treatment, and improving prison conditions can save lives and protect communities. As the White Paper concludes: “Good health is a human right.”
The White Paper has been developed in collaboration with EUSAT-TB Research | Campaigns in Global Health | KNCV TB Plus | Programa Nacional de Control de Tuberculosis, Paraguay | Instituto Nacional de Enfermedades Respiratorias y del Ambiente "Dr Juan Max Boettner" - INERAM | ISPUP - Instituto de Saúde Pública da Universidade do Porto | Radboudumc | Vall d’Hebron Institute of Research (VHIR) - Vall d'Hebron Institut de Recerca | Instituto de Investigaciones en Ciencias de la Salud - Universidad Nacional Asunción | Facultad de Medicina - Universidad Nacional de Concepción