The meeting was unique in the diversity of its participants and the fact that it allowed for informal networking and cross –pollination of ideas between national policy-makers, researchers, and non-governmental organisations. Jason Eligh, Regional Coordinator for the United Nations Office on Drugs and Crime (UNODOC) says that it is important that senior prison officials, like commissioners understand the work civil society does, and see them as a potential local resource, rather than a confrontational partner. “On the other hand”, he says, “civil society should see prison officials as people who are genuinely facing a problem but have significant constraints in how they respond: so that there is some sympathy on both sides, and some understanding.”
During the meeting best practices were shared which stimulated discussion. For example Medicins Sans Frontieres described their successful integrated primary health care and HIV programme at selected prisons in Malawi, and a presentation from the Lesotho Correctional Services Department outlined their robust policies and practice.
Much of the meeting was devoted to discussing the potential of Treatment as Prevention (TasP), as a new strategy for HIV prevention in prisons. TasP means that all HIV-positive inmates are offered antiretroviral therapy, no matter how advanced the progression of their HIV infection. Recent research has shown that when a person’s viral load has stabilised on treatment, the likelihood of transmitting the virus is minimal. This in this model, treatment becomes prevention.
The implications of this strategy are considerable – much larger numbers of people on treatment, the need to increase the scale of HIV testing, more drugs, better adherence, improved laboratory facilities. Despite these challenges, participants expressed great interest in the strategy and its potential to reduce HIV transmission in prisons.