Memorandum delivered by the Treatment Action Campaign (TAC) and SECTION27 to a representative of the Department of Justice and Correctional Services (DJCS) at the SA TB Conference on Thursday 12 June 2014.
Department of Justice and Correctional Services must urgently recognise and confront the deadly TB epidemic in its prisons.
TB is the number one cause of natural deaths in South Africa’s prisons. Due to poor data collection, the prevalence of TB and DR TB in prisons is unknown but is widely suspected to be dangerously high – the DJCS itself has estimated the prevalence in prisons to be between three and seven times that of the general population.
Overcrowding, poor ventilation, unreliable access to ARV and TB treatment and the failure to screen properly have characterized prisons for too long.
The DCS has been, in the words of the Constitutional Court, “pertinently aware” of the crisis of TB in prisons for many years yet has “failed to take adequate, or any, measures” to stop it. This unacceptable lack of action amounts to a denial of a public health emergency and is therefore a grave threat to human rights and public health.
We note the recent appointment of Minister Masutha in the newly merged Department of Justice and Correctional Services. We call for his appointment in the new department to mark a new era in which the DJCS acknowledges the TB crisis as a public health emergency and urgently addresses it as such.
We call for:
1. Comprehensive monitoring and transparent reporting of HIV, TB and DR TB indicators in prisons. In particular, we call for improved collaboraton between the DJCS, NDoH and researchers to establish levels of MDR TB in prisons and the role of prisons in fuelling the TB epidemic outside prisons;
2. Compliance with law and policy, including respecting the duty to inform prisoners of their rights to access health care services and reduce their risk of TB infection and transmission.
3. Prisoners to be included at all levels – from facilities to national – of planning and implementing TB prevention efforts.
4. The development of a plan to address infection control and overcrowding in prisons, linked to the NSP targets;
5. Heads of Prisons should be compelled to particupate in Provincial TB control ‘war rooms’;
6. Minister Masutha to convene a roundtable inclusing civil society in regard to overcoming the TB crisis in prisons.