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BMJ. Sep 10, 2005; 331(7516): 576.
PMCID: PMC1200601

Making prison health care more efficient

Europe's initiative and progress should be noted
Alex Gatherer, former honorary visiting fellow

Editor—While it is very useful to be reminded about the need for cost efficiency in prison health services, the importance of effective prison health services to public health in general should also be emphasised. Awofeso did not have the space to underline the public health importance of good prison health in his editorial on making prison health more efficient.1 His concentration on experience in the United States, the United Kingdom, and Australia also pays insufficient attention to initiatives in Europe.

For example, the World Health Organization's Health in Prisons Project, launched in 1995, now has 10 years' experience in promoting health in prisons and custodial settings.2 Thirty two countries of Europe are committed to the project, through their prison health policies, showing a willingness to develop best practice guidance on preventing disease and promoting health in prisons on the basis of evidence and experience.3 The project will hold its 10th annual meeting in London next month. The meeting will review progress so far, the impact of its several consensus papers and policy documents, and the priorities for future action.

All countries are facing the same important public health issues, to which good prison health can make a worthwhile contribution. It is time for a global initiative, so that all regions of the world can learn from each other in this challenging area of public health.


Competing interests: AG is a temporary adviser to the WHO Regional Office for Europe's Health in Prisons Project.

More information about the WHO project can be obtained from Lars Moller (tni.ohw.orue@OML) and www.hipp-europe.org


1. Awofeso N. Making prison health care more efficient. BMJ 2005;331: 248-9. (30 July.) [PMC free article] [PubMed]
2. WHO Regional Office for Europe. Health in prisons project. Copenhagen: WHO, 1995. (www.hipp-europe.org)
3. Gatherer A, Moller L, Hayton P. The World Health Organization Health in Prison Project after 10 years: persistent barriers and achievements. Am J Public Health (in press). [PMC free article] [PubMed]

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