EU agencies for disease prevention and drugs have together launched a toolkit to support efforts to eliminate viral hepatitis in Europe's prisons.
The initiative by the European Centre for Disease Prevention and Control and the European Drugs Agency, supports the World Health Organisation’s target to eliminate viral hepatitis as a public health threat by 2030.
Published ahead of Prisoners’ Justice Day (10 August), the guide aims to support hepatitis B and C prevention and care in prisons across Europe. It is primarily intended for professionals working in prison healthcare services and provides information on how to set up interventions to prevent and control viral hepatitis in these settings.
The number of prisoners in the EU was around 499,000 in 2023, equivalent to 111 prisoners per 100,000 inhabitants, according to the European Commission, representing a 3.2% increase compared with 2022.
In the EU, hepatitis B and C prevalence is highest among certain populations, including migrants, people who inject drugs, men who have sex with men, sex workers, and people in prison.
This makes prisons a high-risk environment for hepatitis B and C transmission, as prison populations and people who inject drugs often overlap, according to the agencies.
“Incarceration and drug use are therefore intertwined and lead to increased risks of infection with communicable diseases,” the toolkit notes.
The scarcity of access to clean injecting equipment in most prison settings further increases the risk, not only for drug use but also for tattoos and body piercings.
Hepatitis B and hepatitis C are major causes of cirrhosis, liver cancer, liver transplantation, and liver related deaths.
The WHO estimates that 10.6 million people in Europe are living with chronic hepatitis B, and 8.6 million with chronic hepatitis C, the majority of whom remain undiagnosed.
Both agencies highlight the unique challenges of addressing this issue in the prison context — including insufficient resources, lack of training, and underdeveloped public health surveillance and monitoring systems — all of which can hinder the implementation of recommendations.
They also stress the need to tackle these infections not only to improve individual health outcomes for prisoners but also to reduce transmission within prisons and in the wider community upon release.
