[ad_1]
Washington DC – Dozens of cultured men looked behind the barred door of a crowded, windowless prison cell, their eyes desperately pleading for sweaty faces.
Their physical discomfort was so palpable, I could almost feel it. Because of my work, I also knew at least one serious invisible risk – that of contracting TB in the cramped and poorly ventilated space.
The visit to the largest prison in Port-au-Prince was part of a research visit. Two years later, the image of these men still haunts my memories – all the more so now that the first-ever United Nations High Level Meeting on Tuberculosis (TBU) is approaching in September and the global spotlight is on. to activate this neglected disease and the conditions that continue to influence its spread.
At the upcoming 22nd International AIDS Conference in Amsterdam from July 23-27, civil society organizations will seek to highlight vulnerable populations. a common position on key issues such as the link between HIV / AIDS and TB and the need for an integrated approach to diagnosis and treatment.
A special session, Friday, July 27, titled "Seizing the Moment of Tuberculosis: Tackling the Challenges of Tuberculosis Management and the Integration of Tuberculosis and HIV", will feature Eric Goosby, UN Secretary-General's Special Envoy on Tuberculosis, Paul Farmer, Partners in Health Co-Founder, and Carol Nawina Kachenga, Zambian Group CITAMplus Former US President Bill Clinton will deliver the opening speech of special sessions.
The magnitude of the prison problem is particularly staggering.In 2016, The Lancet published a study of Kate Dolan and her colleagues at the University New South Wales explaining that of the total global prison population of 10.2 million, 2.8% or 286,000 have active tuberculosis.
3.8% or 389, 000 also have HIV. Tuberculosis believes that the risk of tuberculosis in prison is on average 23 times higher than in the general population.
The high rate of HIV in prisons is exacerbated by the lack of options for prevention and badual violence. However, even prisoners living with HIV who can overcome barriers to treatment are at greater risk of contracting TB.
Data from sub-Saharan Africa show a prevalence of HIV infection among inmates from 2.3% to 34.9%. From 0.4 to 16.3%
Overcrowding appears to be the main cause of the tuberculosis epidemic in prison. Dolan et al. Reject responsibility for the practice of mbad incarceration of people who inject drugs. They advocate decriminalization, alternatives to incarceration and access to opioid agonist therapy.
Another factor of overcrowding is the use of pre-trial detention and slow decision-making. Slow judicial procedures have been attributed to mbadive overcrowding in prisons in the Philippines, a country with a high level of TB, including drug-resistant TB.
In Port-au-Prince, the national penitentiary was built for 800 prisoners, but now houses 4600; the tuberculosis rate is 17 times higher than that of the general population of the country. There is no prison hospital in which the patient can be isolated and treated properly.
Prisoners are malnourished, with only one or two meals a day and little or no protein, making TB – caused by a bacterium in suspension – even more likely. The state of the world's prisons ensures that they are "factories" for the transmission of tuberculosis, including drug-resistant tuberculosis – now the biggest killer of infectious diseases in the world. Combating prison conditions is therefore essential to ending the disease.
Some countries are directly addressing the issue. Mongolia, for example, reported a two-thirds reduction in TB between 2001 and 2010 among inmates through active TB case finding and improvements in health services and living conditions. Reduced prison populations and improved nutrition were important for this success
In a project in Zambia, supported by TB REACH, peer educators were trained among the prison population to support TB screening and HIV counseling. This approach proved very effective and sustainable as peer educators knew the prison culture and were enthusiastic and committed.
Tuberculosis experts also point to the need for screening and treatment, not only for active TB, but also for latent TB infection, which is widespread among prisoners, to support better prevention of TB. The preventive therapy of tuberculosis, an antibiotic treatment, has proved very effective but is not yet widely used in countries with heavy load.
At Port-au-Prince Penitentiary, I saw the dedicated work of an NGO, Health Through Walls, providing anti-TB and HIV services, despite adverse conditions. With the help of USAID and the Global Fund, they provide diagnoses of HIV and TB, including the use of the latest methods, as well as nutritional treatments and supplements, in 11 prisons. in Haiti. With a tiny budget, they save many lives.
At a Civil Society Tuberculosis Hearing held earlier this year at the United Nations, the UNHLM Prep Assembly, Donald Tobaiwa, of the Jointed Hands Welfare Organization, Zimbabwe called for urgent action to combat tuberculosis in prisons, as well as in the mining industry.
"What are countries doing about it?" He asked. "The question, he said, was not what it costs to find people with TB, but what it would cost us if we did not find them."
UNHLM advocates plan to make it their rallying cry. State. With a strong commitment to finding TB cases, including those who are hiding in the prison population, and support from Member States for an independent and regular badessment of progress, the meeting can be a turning point in the fight against this disease.
[ad_2]
Source link
