Stop TB, fight poverty!
22-03-2002 News Release 02/20
ICRC message marking World Tuberculosis Day, 24 March
ICRC tuberculosis control programme in prisons of the southern Caucasus
Geneva (ICRC) - Tuberculosis is a disease of poverty in the prisons of countries in transition, as the detainees often come from the margins of society.
During the visits they carried out in the early 1990s to prisons in Azerbaijan, Georgia and Armenia in order to assess the detainees'conditions of detention, delegates of the International Committee of the Red Cross (ICRC) found that TB was rampant and that the disease was probably one of the primary causes of the high mortality among inmates. The prevalence of tuberculosis in the prisons was up to a hundred times higher than in the population at large.
Working with the respective Ministries of Justice and Health, the ICRC set up a TB control programme in prisons in these three former members of the USSR. The treatment strategy used was DOTS (Directly Observed Treatment, Short-course). The programme was initiated in Azerbaijan in 1995, followed by Georgia in 1998, and treatment is about to begin in Armenia.
This endeavour is based on the firm political will of the ministries concerned to combat the disease by means of the DOTS strategy, which was already in use in the three countries but had not been introduced in prisons. The programme involves six requirements: (1) a hospital for TB-infected detainees with well-trained staff; (2) a highly reliable reference laboratory for diagnosis ; (3) a health education programme targeting groups at risk (detainees and guards); (4) screening for TB in all facilities throughout the penitentiary system; (5) access to diagnosis and treatment for all categories of inmates (including women, high-security detainees and those on remand); and (6) computer monitoring of the programme, in particular the cure rate and multi-drug-resistant cases.
The number of patients with the multi-drug-resistant form of the disease, which results from incomplete or irregular treatment with TB drugs, is extremely worrying. The ICRC programme has confirmed that systematic screening in all places of detention significantly reduces this phenomenon.
In 1998, the rate of multi-drug resistance in prisons in Georgia was 21.8%. Today that figure has fallen to 8.6% following the programme conducted by the ICRC with the Ministries of Justice and Health. The cure rate in this programme has reached 75%.