The Human Immunodeficiency Virus (HIV), Tuberculosis (TB) and Hepatitis C (HCV) – are a major health concern in prisons, evidenced by the fact that prevalence rates tend to be substantially higher among prison populations than in the general population. Prisons and other places of detention are high-risk environments for the transmission of these diseases. This is related to the over-incarceration of vulnerable and disadvantaged groups who carry a disproportionately high burden of disease and ill-health; the criminalisation of drug users and high levels of injecting drug use; overcrowded and substandard prison conditions; inadequate health care; and the denial of harm reduction services.

Over the past 20 years, from an Irish perspective, there has been significant improvement in medical services for the prison population. The Irish Prison Service (IPS), responsible for the prisoners and their health, has made significant investment since 1999 in better healthcare facilities for prisoners1. In 2001 the IPS introduced drug treatment plans and healthcare plans, Hep B vaccine was made accessible to prisoners, nurses were employed, drug free units were expanded, and methadone treatment was implemented. In 2006 the IPS published a drugs policy ‘Keeping drugs out of prison’. However, there still remains a lack of information available that would assist public authorities in making decisions with regards to these services.

While some progress has been made in the adoption of monitoring mechanisms for infectious diseases in Irish prisons, this progress is arguably less than sufficient or consistent in meeting the standards of human rights-based prison monitoring. As has been acknowledged above, the absence of adequate medical services in prisons can contribute to, or even constitute, conditions that meet the threshold of ill treatment. Presently, to our knowledge, inspection of infectious diseases is not formally included in the criteria for inspection of places of detention. Prison monitoring is often separated from health care inspection guidelines, thus leaving gapsin terms of coherent recording and monitoring. This separation is less than optimal in terms of services being positioned to provide an effective and coherent national response to prisoner need. This report is part of a larger international project that seeks to address this gap.