In many countries in our region (Eastern Europe and Central Asia), the issue of quality and access to health care in prisons is still an open question. With the high prevalence of infectious diseases such as HIV and tuberculosis in prisons, problems with access to quality care, lack of qualified staff, and limited resources for diagnosis and treatment of various diseases, the need to reform prison medicine remains particularly urgent. In recent years, several countries in the region have taken steps to improve the situation, seeking to introduce modern standards of care and to bring the management of prison medicine under the control of civilian health authorities.
On November 19-20, 2024, a regional consultation on reforming the penitentiary medicine system in EECA countries was held in Yerevan. Organized by the Eurasian Movement for the Right to Health in Prisons with the support of the Robert Carr Foundation, this meeting brought together representatives of Ministries of Health, Ministries of Interior, penitentiary systems, and their medical services from Armenia, Kazakhstan, Moldova, and Ukraine. The central topic was the experience of Armenia, the first country in the region to transfer the functions of penitentiary medicine to the Ministry of Health. During the consultation, participants discussed the steps taken by Armenia. They assessed the possibilities of adapting these solutions in their own countries. Representatives from Kazakhstan shared their significant experience with reform. At the same time, delegates from Moldova and Ukraine analyzed their colleagues’ experiences and considered the prospects for implementing similar changes in their countries.
The transfer of prison medicine to civilian health authorities is an important step towards ensuring equal access to quality health care for people in prisons. Armenia’s experience proves that such a reform is possible if the state assumes responsibility for the health of all citizens, regardless of their status. The main goal of the reform is not only organizational changes in the management system but also to improve the quality of medical care, to introduce new standards of treatment and prevention of diseases, which are often particularly acute in prison settings.
The experience of Armenia and Kazakhstan, where prison health care reform has also been implemented, demonstrates that transferring these functions to the Ministries of Health can have such positive results as increased trust of prisoners in civilian medical staff; improved quality of services; increased possibility to use national mechanisms for protection of the right to health; access to a wider range of services; possibility to provide a unified medical information space; independence of health care personnel from the administration of penitentiary institutions.
The regional consultation in Yerevan was an important step in the development of penitentiary medicine in the EECA region. The exchange of knowledge and best practices allowed participants to assess the current situation and identify key areas for further reforms. “Joint efforts will help us move faster in ensuring the right to health for all, including people in prison,” summarized Anna Koshikova, Executive Director of the Eurasian Movement for the Right to Health in Prisons. “The challenge now for countries in the region is not only to adapt successful models to national contexts but also to ensure their sustainable implementation so that health care in prisons truly meets international standards and patients’ needs.”