Prisoners have the right to humane treatment and appropriate medical care. The relationship between physician and prisoner is governed by the same ethical principles as that between the physician and any other patient. There are strong public health reasons for reinforcing the importance of these rules. The recently reported increase in incidence of tuberculosis amongst prisoners in a number of countries reinforces the need for considering public health issues when designing new prison regimens, and for pressing for reforms of existing penal and prison systems.
Prisons can be breeding grounds for infection.
Overcrowding, lengthy confinement within closed, poorly lit, badly heated and consequently poorly ventilated and often humid spaces are all conditions frequently associated with imprisonment and which contribute to the spread of disease and ill-health. Where these factors are combined with poor hygiene, inadequate nutrition and limited access to adequate health care, prisons can represent a major public health challenge. Keeping prisoners in conditions which expose them to substantial medical risk constitutes a humanitarian challenge. An infectious prisoner poses a risk not only to other prisoners but also to prison personnel, the prisoner's relatives, other prison visitors and the wider community when the prisoner is released. The most effective and efficient way of reducing disease transmission is to improve the prison environment, targeting overcrowding for the most urgent action.