The new toolkit is designed to support the implementation and scale-up of hepatitis B and C interventions in prisons across Europe. It also reinforces the principle of 'equivalence of care', ensuring that people in prison receive healthcare comparable to that available in the community.
People in prison experience higher levels of viral hepatitis than the general population, making them a key group for targeted prevention and treatment. In Europe, individuals entering prison are also more likely to have a history of injecting drug use — a major risk factor for hepatitis B and C virus transmission. Sharing of injecting equipment and other risk factors — such as unsafe tattooing or body piercing practices, sharing of razors and unprotected sex — make prisons a priority setting for targeted viral hepatitis prevention and treatment interventions.
Short sentences and repeat incarcerations mean that same group of people often move between prison and the community. For this reason, tackling health problems such as viral hepatitis in prison settings can also deliver health benefits to the wider community by driving down the overall disease burden and preventing future transmission of infections. This is known as the 'community dividend'.
The toolkit consists of four key sections: background, strategy development, strategy implementation and monitoring and evaluation. It includes links to relevant public health guidance, and practical tools to understand the context, and define and implement an elimination strategy inside prisons. Examples from prisons in Germany, Spain, France, Italy and Luxembourg, are provided, illustrating models of care.
In the toolkit, the EUDA and ECDC provide practical, evidence-based information for those working in prison healthcare on how to set up interventions to prevent and control viral hepatitis in these settings.
The information is also likely to be relevant to other audiences, including policymakers, security staff, people living in prison, peer support workers, and voluntary workers. Further support for people working in prison healthcare will be available in the form of dedicated training sessions provided by EUDA and ECDC in the coming months to facilitate the effective implementation of the toolkit and scale-up of services.
