Prison Health Expert Group Progress and Future activities

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Prison Health Expert Group Progress and Future activities (including PAC Side event on Prison

Prison Health Expert Group Progress and Future activities (including PAC Side event on Prison Health and Oslo Declaration) CSR meeting Riga, Latvia, October 15 -16, 2009 Ms Ingrid Lycke Ellingsen Mr. Zaza Tsereteli, MD, MPH

Declaration on Prison Health Declaration is based on the already approved principle: that persons

Declaration on Prison Health Declaration is based on the already approved principle: that persons in detention have the same right to health care as persons living in the society at large. Equality of care. WHO - “Prison health policy should be integrated into national policy. Public health should be closely linked to the prison health service. This applies to all matters but is particularly important for communicable diseases”.

Declaration Main aims: 1. To raise awareness among the countries within the NDPHS Region

Declaration Main aims: 1. To raise awareness among the countries within the NDPHS Region of the current situation regarding the health of and healthcare provided in and out of Prison settings 2. To call for marked improvements in the current situation 3. To discuss on transparency of practice and policies – for inmates and the community professionals Aimed for: policy makers politicians governors/chiefs of prisons - senior staff involved in practice at prisoner level

Declaration (Current status) May – First Draft June – Distributed for comments to the

Declaration (Current status) May – First Draft June – Distributed for comments to the NDPHS EGs and PH EG members. Consultations in several countries with Mo. H and MOJ ( Lithuania, Latvia, Estonia, Poland) July – Consultations with WHO, Denmark and Russia. August – Draft is distributed to the CSR members and Ministries of Justice. September – Final version for Declaration is prepared and distributed to the Ministries of Health and Ministries of Justice. October – Presentation at the CSR meeting in Riga November 25 - Adoption of the Oslo Declaration on Prison Health

Revision of Declaration Following countries have commented the draft Declaration and have sent their

Revision of Declaration Following countries have commented the draft Declaration and have sent their suggestions/amendments: Latvia, Lithuania, Denmark, Germany, Canada, Sweden, Russia, Poland, Norway, Finland All Expert Groups of NDPHS WHO– Euro (HIPP project), EMCDDA, NCM Several experts and professionals from the field of Public Health and Prison Health

Side event on Prison Health Good Prison Health – Better Public Health – Safer

Side event on Prison Health Good Prison Health – Better Public Health – Safer Society

Side event What: 1 day meeting. Protection of prisoners is protection of our communities

Side event What: 1 day meeting. Protection of prisoners is protection of our communities Where: Oslo, Norway (Hotel Bristol) When: 24 November, 2009 Who: PH EG, representatives for all EG of NDPHS, MOJ, MOH, EMCDDA, WHO HIPP, Portugal, Canada, NGOs

Draft Programme of Side event 10: 00 – 11: 30 1. Opening of the

Draft Programme of Side event 10: 00 – 11: 30 1. Opening of the Conference, presentation of scope and possible outcome – State Secretary Mr. Terje Moland Pedersen, Ministry of Justice, Norway 2. Welcoming remarks by the present Ministers of Justice from the Partner Countries 3. “Prison Health - a challenge to public health” - Mr. Lars Møller, Technical Officer for Prison and Health, Division of Country Health Systems, WHO 4. “Prison health in the NDPHS countries” – Ms. Ingrid Lycke Ellingsen, Chair of the PH EG. “Prison Health in Russia” - TBC

Draft Programme (continuation) 11: 35 – 13: 15 5) Prison health reforms – presentation

Draft Programme (continuation) 11: 35 – 13: 15 5) Prison health reforms – presentation of the situation in some countries: A) Norway – Mr. Jon Hilmar Iversen, Head of division, Norwegian Directorate of Health B) Canada – Ms. Ann Marie Hume (TBC) C) Portugal – Mr. Henrique Barros, National Coordinator for HIV/Aids D) Poland – Mr. . Leszek Markuszewsk, Director, Office of Health Care, Central Board of Prison Servicesi E) South East European Health Network – TBC 13: 15 -14: 30 Lunch

Draft Programme (continuation 2) 14: 30 – 16: 10 6) NDPHS EG on PHC

Draft Programme (continuation 2) 14: 30 – 16: 10 6) NDPHS EG on PHC – “Bridging the gap between the health services in prison and the civilian world - what could be the role of primary health care? ” – Mr. Simo Kokko 7) NDPHS EG on HIV/AIDS – “HIV prevention and care - emerging issues in our region“ – Mr. Paul Leinikki 8) NDPHS SILWHA EG – “Healthier lifestyles for would-be, current and past prisoners - a “silver bullet” or a “red herring”? – Mr. Mikko Vienonen 9) The Expert Group for Cooperation on Children at Risk - Bertil Mahs "Prevention of criminal behaviors in young people with experiences of out -of-home care” – Mr. Bertil Mahs

Draft Programme (continuation 3) 16: 20 – 17: 15 10. EMCDDA –"Infectious diseases among

Draft Programme (continuation 3) 16: 20 – 17: 15 10. EMCDDA –"Infectious diseases among injecting drug users and harm reduction services in Europe - more focus needed on prisons" – Mr. Lucas Wiessing, European Monitoring Centre for Drugs and Drug Addiction 11) Draft Declaration on Prison Health, conclusion, final remarks, summing up. 12) Closing of the Conference

PH Expert Group Progress report for 2009 and future plans

PH Expert Group Progress report for 2009 and future plans

Prison data from NDPSH partner countries Norway - 3 326 prisoners. No registration of

Prison data from NDPSH partner countries Norway - 3 326 prisoners. No registration of HIV and TB in prisons. Denmark - 3. 648 prisoners. Estonia – 3709 prisoners. Prisoners with registered HIV 523 and prisoners with TB 16. Latvia - 7 122 prisoners; HIV for this period 451, TB 54. Finland – 3526 prisoners. Lithuania - 8295 prisoners, HIV 289, TB 114. Northern Germany: Bremen: 652; Hamburg: 2066; Schleswig-Holstein: 1504; Niedersachsen: 6392; Mecklenburg-Vorpommern: 1449. Poland: 85 546 Prisoners. HIV 347; TB 562. NW Russia: 87 500 prisoners. HIV 7622; TB 2946. Total number of Prisoners: 214 610

TB cases in the Penitentiary system of NW Russia Region Total number of cases

TB cases in the Penitentiary system of NW Russia Region Total number of cases Newly Diagnosed cases Prevalence per 100 000 inmate Rep. Of Karelia 659 52 1000, 77 Rep. Of Komi 588 230 1270, 02 Arkhangelsk Region 324 155 1106, 19 Kaliningrad Oblast 184 58 1307, 78 Murmansk Oblast 176 64 864, 16 St. Petersburg and Leningrad blast 221 441 2520, 14 Total in NW Russia 2946 1220 1387, 4 Total for Russia 42346 14853 1664, 16

HIV in the Penitentiary system of NW Russia Region Total number of cases Newly

HIV in the Penitentiary system of NW Russia Region Total number of cases Newly Diagnosed cases Prevalence per 100 000 inmate Rep. Of Karelia 526 40 769, 82 Rep. Of Komi 585 48 265, 05 Arkhangelsk Region 311 28 199, 83 Kaliningrad Oblast 465 46 1037, 2 Murmansk Oblast 751 128 1728, 33 St. Petersburg and Leningrad blast 4139 2131 12177, 84 Total in NW Russia 7622 2495 2837, 36 Total for Russia 49213 10447 1170, 5

PH EG Member Countries and Organisations 1) Norway – Chairman 2) Finland 3) Sweden

PH EG Member Countries and Organisations 1) Norway – Chairman 2) Finland 3) Sweden 4) Lithuania 5) Latvia 6) Estonia 7) Russia (joined in April, 2009) 8) Poland 9) Germany 10)Canada 11)Belarus 12)Portugal 13)Denmark (joined in June, 2009) 14)WHO HIPP

PH EG Meetings 1) 1. Vilnius (February): Canada, Finland, Germany, Latvia, Lithuania, Norway, Poland,

PH EG Meetings 1) 1. Vilnius (February): Canada, Finland, Germany, Latvia, Lithuania, Norway, Poland, Sweden, WHO HIPP, Eurasian Harm Reduction Network (EHRD), University of Bremen, HIV/AIDS EG, PHC EG; 2) 2. Helsinki (June): Finland, Germany, Norway, Poland, Russia, Sweden, FILHA (Finland); 3) 3. Oslo (November) Canada, Denmark, Estonia, Finland, Germany, Latvia, Lithuania, Norway, Poland, Russia, Sweden, WHO HIPP.

Some of the activities of PH EG members The Chair and the PH EG

Some of the activities of PH EG members The Chair and the PH EG members Olga Zeile, Latvia, Ursula Scheben, Germany, and Anders Nystedt, Sweden, participated in the International Conference on Prison Health at the 90 th anniversary of the Lithuanian Penitentiary system. Ms. Rauni Ruohonen, Finland, visited Murmansk Oblast on 9. -13, March, in the frame of the Murmansk TB/HIV project. St. Petersburg and Leningrad Oblast, in April and May Ms. Ursula Scheben, Germany, participated in the 4 th European meeting of German speaking countries on AIDS help (Gesundheitsförderung in Haft), which took place in Vienna, Austria, on April 15 -17 Mr. Anders Nystedt, Sweden, gave two presentations “International experience and methods of active HIV prevention” and “Epidemiological situation and HIV/AIDS & TB care system in the Nordic countries” at a meeting in Kaliningrad, Russia

Some of the activities of PH EG members Ms. Birute Semenaite, Lithuania, participated in

Some of the activities of PH EG members Ms. Birute Semenaite, Lithuania, participated in the 1 st Conference of the Connections Project ”Joining the Dots: criminal justice, treatment and harm reduction" 25 -27 March, Krakow, Poland The ITA together with the Lithuanian representative of EG participated in the 4 th International conference «Actual problems of penitentiary medicine» . This conference took place in Minsk on September 8 -10. The Chair and the ITA and several members of EG have participated in HIPP Network Meeting and International Conference ‘Prison Health Protection’ , organized by WHO Ms. Olga Zeile (Latvia) is taking active part in the Project „HIV/AIDS PREVENTION AND CARE AMONG INJECTING DRUG USERS AND IN PRISON SETTINGS IN ESTONIA, LATVIA AND LITHUANIA”, established in 2006 (funded by the Dutch government).

General Strategy Scaling up knowledge, sharing best practices and Policy transfer between countries. The

General Strategy Scaling up knowledge, sharing best practices and Policy transfer between countries. The network of experts and their respective Institutions facilitating such exchange and intercountry collaboration. Focusing more sharply on setting standards, policy and strategy dialogue and technical advise.

Strategy Goal # 1 To identify and to decrease gaps in provision of health

Strategy Goal # 1 To identify and to decrease gaps in provision of health care to prisoners, at least equivalent to that available for the outside population, in order to support their healthy return to the community Action: By January 2012, the PH EG will have concluded preliminary assessments of Prison Health service organizational structures and their influence on health care access at Health care institutions in partner countries and will make recommendations to ensure all patient-inmates have improved access to health care at each institution

Strategy Goal # 2 Support NDPHS partner countries in their efforts to meet the

Strategy Goal # 2 Support NDPHS partner countries in their efforts to meet the UN Millennium Development Goals towards HIV/AIDS and TB control, by developing preventive programs and control mechanisms within the penitentiary system Action: Develop by January 2012, a comprehensive programme on HIV/TB prevention and management within the Penitentiary system of NW Russia. During the 4 -year period collect and disseminate the best practices on effective comprehensive HIV/AIDS prevention interventions and MDR TB management in NDPHS partner countries

Strategy Goal # 3 A gender-sensitive prison policy in order to meet the basic

Strategy Goal # 3 A gender-sensitive prison policy in order to meet the basic health and welfare needs of women and women accompanied by children in prison is developed Action: Follow-up on Thematic report on Women’s Health in Prison settings. Collaborate with prisons/jurisdictions that have implemented successful programes on Children staying with their mothers in prison; promote national and international seminars to share experiences and examples of effective practice

PH EG activities (2010) EG meeting in Arkhangelsk (Russia) – March EG meeting in

PH EG activities (2010) EG meeting in Arkhangelsk (Russia) – March EG meeting in Gdansk (Poland) – June or September Preparation of Assessment of Prison Health Care systems in 2 -3 NDPHS Partner countries (possible Lithuania and Latvia) – in collaboration with PHC EG Close collaboration with WHO HIPP Start to Develop TB/HIV Co-infection management programme( with the active involvement of NW Russia) – in collaboration with HIV/AIDS EG Follow-up on Thematic report on Women’s Health in Prison settings - Children staying with their mothers in prison - in collaboration with Children at risk group