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Southern Caucasus: Towards TB-free prisons

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  • Southern Caucasus: Towards TB-free prisons

    International Committee of the Red Cross News
    March 24 2004

    Southern Caucasus: Towards TB-free prisons
    Every year, two million people die of tuberculosis (TB), and another
    eight million contract the disease.


    In most countries of the Commonwealth of Independent States, it has
    proven difficult to bring the disease under control because of the
    social and economic situation and the breakdown of the health-care
    system. In the southern Caucasus, where TB causes enormous suffering
    and death in the prisons, the ICRC has been working with the national
    authorities for many years to provide treatment for prisoners. In
    1995, when the ICRC launched a TB-control programme in the prisons of
    Azerbaijan, the disease was at least 60 times more prevalent among
    inmates than among the country’s civilian population. In 1998, the
    ICRC began providing support for implementation in Georgian prisons
    of the DOTS (Directly Observed Treatment, Short Course) strategy
    recommended by the World Health Organization. In 2002, the ICRC
    extended its support for this programme to Armenia.

    If prisoners have TB when they are released, they bring the disease
    with them back into society. Since TB is a national public-health
    issue that also affects the population outside prisons, the ICRC is
    coordinating its activities in prisons with others working on behalf
    of the population at large, including the donor community, to
    reinforce joint efforts to fight the disease. Since 1995, the ICRC
    has provided support for the treatment of more than 8,000 prisoners
    in the southern Caucasus. One of the problems it has encountered is
    that prisoners are sometimes released before they have completed
    treatment, without proper coordination between the authorities
    responsible for health care inside prisons and those responsible for
    national TB programmes.

    Major challenges still lie ahead. Outbreaks of multidrug-resistant TB
    in prisons could cause these dangerous strains to spread into the
    community through the families of prisoners, released prisoners, and
    prison staff. In addition, as the number of AIDS cases rises
    throughout the former Soviet Union, opportunistic TB infections will
    increasingly destroy families and whole communities. In response, the
    resources of the entire public-health system must be brought to bear
    on this already devastating epidemic. Urgent action must be taken, in
    particular to treat drug-resistant patients and reduce the
    progression of HIV.
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