Summary

In the report, the Special Rapporteur addresses the relationship between the right to health and specific forms of deprivation of liberty and confinement in penal and medical regimes. Detention and confinement remain the policy tools preferred by States to promote public safety, “morals” and public health. In fact they do more harm than good to public health and the realization of the right to health.

The Special Rapporteur stresses that people should not be imprisoned simply because of their sexual orientation, gender identity and expression, illicit drug use, HIV status or because they are living with disabilities. Neither should sex workers or those carrying infectious diseases. He calls for national laws that criminalise people on the basis of stigma or prejudice to be removed from the statute books.

The report also looks at the cases of children and women deprived of their liberty. The Special Rapporteur expresses concern about legal restrictions of access to sexual and reproductive health products, services and information, including for the termination of pregnancy. This has led to more women being imprisoned. States must carefully reflect on how to end this phenomenon.

He also highlights the issue of tuberculosis as a public health-based form of detention. The number of cases of tuberculosis cannot be reduced simply by placing persons with the disease behind bars or in closed wards. Confinement not only puts them at risk of inadequate access to treatment and support, but also fuels the spread of the infection.

Recommendations

Countries around the world must stop routinely locking up citizens because of stigma, prejudice or health conditions. The Special Rapporteur calls for the full implementation of the United Nations Standard Minimum Rules for the Treatment of Prisoners (the Nelson Mandela Rules), and for the development of supportive community-based services as alternatives to detention and confinement in various cases.

He recommends abolishing detention for children, and starting work on the full elimination of institutional care of children under age five. He also recommends continuing the very difficult but important conversation towards ending the confinement of children and adults with disabilities, in particular with intellectual and psychosocial disabilities.