Monitoring harm reduction implementation in European prisons: public health and human rights approaches

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1 Monitoring harm reduction implementation in European prisons: public health and human rights approaches Cinzia Brentari, Harm Reduction International ~ 14 June 2015 ~ cinzia.brentari@ihra.net

2 ABOUT US: HARM REDUCTION INTERNATIONAL HRI is London based leading non-governmental organisation working to reduce the negative health, social and human rights impacts of drug use and drug policy by promoting evidence-based public health policies and practices, and human rights based approaches to drugs.

3 WHATWEDO Evidence and Advocacy Research and policy analysis informing advocacy across our sector: The Global State of Harm Reduction Funding for Harm Reduction Human rights based policy Human rights abuses and drug enforcement go hand in hand. HRI challenges laws, policies and practices that generate harm. International conferences Harm reduction is a global movement. Sector strengthening HRI builds advocacy coalitions and supports emerging harm reduction networks to strengthen the international harm reduction sector. - Coordinating the European Harm Reduction Network,

4 GLOBAL AVAILABILITY OF NEEDLE AND SYRINGE PROGRAMMES

5 GLOBAL AVAILABILITY OF OPIOID SUBSTITUTION PROGRAMMES

6 A PUBLIC HEALTH APPROACH TO INFECTIOUS DISEASES PREVENTION IN PRISON PRIDE EUROPE STUDY - Objective: Analise the levelsof adherenceon harmreductionservices in prisons to national and international guidelines questionnaire to all prisons medical doctors (UNODC 2012 HIV Prevention, treatment and care in prisons and other closed settings: a comprehensive package of interventions and WHO/UNODC/UNAIDS 2007 Effectiveness of interventions to address HIV in prison ) Geographical coverage, 4 EU states: Belgium: 35 prisons. Research by the Prison Administration and Ghent University Austria: 28 prisons. Research by the Prison Administration Italy: 205 prisons. Research by FederSerD, Denmark: 49 prisons, Centre for Alcohol and Drug Research, Aarhus University Co- funded by the EU

7 PRIDE EUROPE: AREAS INVESTIGATED

8 PRIDE EUROPE: AREAS INVESTIGATED

9 Total adherence score to international recommendations Max Maximum adherence level:12 IQR 75% Médiane Moyenne All countries scoring only between 3.5 and 4.5 IQR 25% Min

10 A HUMAN RIGHTS APPROACH TO INFECTIOUS DISEASES PREVENTION IN PRISON Several human rights conventions enshrine prisoners rights, including their right to the highest attainable standard of health (UDHR, ICCPR, ICESCR, CAT, ECHR, etc.) Standards relating to prisoners health have been set by human rights and public health bodies International, regional and national human rights monitoring mechanisms have been put in place to ensure compliance with those conventions and standards, and to ultimately protect prisoners rights (SPT, CPT, NPMs ). Generally grounded in the prevention of torture and ill treatment, their mandates do encompass health issues and rights. The European Court of Human Rights also has growing body of case law of prisoners rights, including health rights.

11 IMPROVING PRISON CONDITIONS BY STRENGTHENING INFECTIOUS DISEASE MONITORING A HRI PROJECT Objective: reduce ill-treatment of persons in detention and improve prison conditions through enhanced and standardised monitoring and inspection mechanisms on infectious diseases (TB, HIV and HCV). Develop a user-friendly tool to generate better informed, more consistent, and sustained human rights monitoring of infectious diseases in prisons by national, regional and international human rights monitoring mechanisms. Working at European level with specific mapping and advocacy work in Greece, Ireland, Italy, Latvia, Portugal, Poland, Spain This project is co-funded by the European Union under the Criminal Justice Programme

12 IN SUMMARY Things we already know Things we need to do Increase civil society engagement and networks of people who use drugs in research Strategise on how best to gather data in key populations/areas Ensure independent mechanism for gathering global data

13 THANK YOU For information: Cinzia Brentari, project manager, HRI