Episode 6 of the Let’s Talk about Health podcast, focuses on the health challenges in prisons across Latin America and the Caribbean. The guest is Mónica Alonso, head of PAHO’s unit for HIV, STIs, viral hepatitis, and tuberculosis.
Key Issues in Prison Health
Overcrowding: Most prisons in the region are overcrowded, with some exceeding 200% capacity, creating ideal conditions for disease transmission.
High Disease Burden: Inmates are disproportionately affected by:
Tuberculosis (TB): 50–100 times more prevalent than in the general population.
Hepatitis C: 17–18 times more common.
HIV, syphilis, and hepatitis B: Also significantly more prevalent, especially among women.
Impact Beyond Prisons
Prisons act as amplifiers of disease. Inmates eventually return to communities, and staff, visitors, and nearby populations are also at risk.
Around 30% of national TB cases may originate from prison environments.
PAHO’s Response and Recommendations
Integrated Health Guidelines: PAHO has published a guide for managing multiple diseases in prisons.
Cost-effective Interventions:
TB screening and treatment can reduce prison TB by 80% and community TB by 40%.
Rapid tests for HIV, hepatitis, and syphilis are affordable and effective.
Collaboration is Key: Success depends on coordination between health and justice sectors, prison staff, and the community.
Final Reflections
Health is a right, even for incarcerated individuals.
Eliminating diseases in prisons is possible with joint efforts.
Mónica Alonso emphasizes the importance of public health as a way to impact entire communities, not just individuals.
