São Paulo, February 19, 2025 (PAHO) – In an effort to address the spread of infectious diseases in prisons, Latin American countries have been exploring actions to eliminate HIV, tuberculosis, hepatitis B and C, measles, and diphtheria in correctional facilities. Overcrowding, violence, and limited access to healthcare exacerbate the situation.
To address this issue, the Pan American Health Organization (PAHO), in collaboration with Brazil's Ministry of Health, organized a regional meeting on February 12 and 13 in São Paulo. The event gathered officials from the Ministries of Health, Justice, and Interior of 15 countries, along with experts, researchers, international organizations, and civil society members.
The meeting provided a platform to discuss the challenges faced by Latin American countries in combating the spread of infectious diseases in prisons, and to share successful strategies and experiences from various nations. More than 130 participants attended the event, both in person and virtually, including representatives from Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, Panama, Paraguay, and Uruguay.
According to Monica Alonso, Head of the PAHO Unit for HIV, Sexually Transmitted Infections, Viral Hepatitis, and Tuberculosis, “Prisons in Latin America and the Caribbean hold millions of individuals, many of whom come from highly vulnerable backgrounds. In addition to pre-existing vulnerabilities, they face overcrowding, violence, stigma, and barriers to accessing healthcare.”
These conditions contribute to the spread of infectious diseases such as HIV, tuberculosis, hepatitis C, and other preventable diseases like hepatitis B, measles, influenza, and diphtheria. “These diseases affect not only the incarcerated population but also prison staff, individuals who enter and exit these environments, children, and the broader community,” Alonso added.
Incarceration rates in South and Central America are growing faster than anywhere else in the world. According to data from the United Nations Office on Drugs and Crime (UNODC), there were over 11 million people incarcerated worldwide in 2021, with 32% of them in the Americas. There is increasing evidence that outbreaks of infectious diseases in prisons not only affect the incarcerated population but also spread to the general public.
Cíntia Rangel Assumpção, General Coordinator of Citizenship and Penal Alternatives at Brazil’s National Penitentiary Policy Secretariat, emphasized that eliminating infectious diseases in prisons requires an intersectoral and multidimensional approach, addressing not only healthcare but also improvements in prison conditions.
“We need to work on issues like overcrowding and the lack of minimum standards for holding individuals, which contribute to the spread of diseases. It is urgent that, as a society, we confront these issues and discuss universal access to healthcare. People in prison must have access to early diagnosis, proper treatment, and continuous follow-up without discrimination or stigma,” she said.
During the meeting, PAHO presented guidelines to the countries aimed at eliminating tuberculosis, HIV, hepatitis, and syphilis in prisons. The organization also discussed recommended vaccination strategies for this population.
Artur Kalichman, General Coordinator of HIV/AIDS Surveillance and Director of the HIV/AIDS, Tuberculosis, Viral Hepatitis, and Sexually Transmitted Infections Department at Brazil’s Ministry of Health, welcomed the opportunity to share experiences and strengthen evidence-based public policies. “It is essential that we discuss how to expand early diagnostic capacity and ensure access to treatment, knowing that this is a public health action that will have an impact not only inside prisons but also for society as a whole,” he stressed.
Incarcerated individuals are disproportionately affected by infectious diseases, particularly HIV and tuberculosis. In the Americas, tuberculosis rates in the prison population are 50 times higher than in the general population. “People in prisons are 7.2 times more likely to live with HIV than adults in the general population. Although we have limited data, it is estimated that around 15% of the total prison population suffers from hepatitis C, 4.8% from chronic hepatitis B, and 2.8% from active tuberculosis. People in prison are a representative sample of the general population. This is where we can address these crucial issues. It is a highly underserved population,” said Andrea Boccardi, Director and UNAIDS Representative in Brazil.
PAHO also presented countries with a tool to improve the health and well-being of incarcerated individuals from a human rights perspective, emphasizing that they can count on the organization’s support for its implementation.
At the conclusion of the meeting, next steps were outlined, including the creation of a regional technical working group, the implementation of a vaccination microplanning tool in prisons with PAHO’s support, and the strengthening of intersectoral cooperation and actions with civil society to advocate for the rights of incarcerated individuals.
HIV/AIDS, tuberculosis, and hepatitis B and C are among the more than 30 infectious diseases and related conditions that PAHO aims to eliminate by 2030 as part of its Elimination Initiative.
