Prison Needle Exchange: Lessons from a Comprehensive Review ...

Population: A Comprehensive Strategy, Prisoners’ HIV/AIDS Support Action
Network 251
• 1999 – Final Report of the Study Group on Needle Exchange Programs, Study Group
on Needle Exchange Programs, Correctional Service of Canada 252
• 2002 – Action on HIV/AIDS and Prisons: Too Little, Too Late – A Report Card,
Canadian HIV/AIDS Legal Network 253
• 2003 – Unlocking Our Futures: A National Study on Women, Prisons, HIV, and
Hepatitis C, Prisoners’ HIV/AIDS Support Action Network 254
• 2003 – Protecting Their Rights: A Systemic Review of Human Rights in Correctional
Services for Federally Sentenced Women, Canadian Human Rights Commission 255
In addition, two reports from House of Commons committees have called for CSC to allow
incarcerated offenders access to harm-reducing interventions in order to reduce the incidence
of bloodborne diseases in a manner consistent with the security requirements within
institutions:
• 2002 – Policy for the New Millennium: Working Together to Redefine Canada’s Drug
Strategy, Report of the Special Committee on Non-Medical Use of Drugs 256
• 2003 – Strengthening the Canadian Strategy on HIV/AIDS, Report of the House of
Commons Standing Committee on Health 257
Taken together, these 11 reports plus this report (Prison Needle Exchange: Lessons from A
Comprehensive Review of International Evidence and Experience) present evidence of the
effectiveness of needle exchange programs and provide ample evi-
dence of the need for such programs in Canadian prisons. In light of
this body of evidence and informed opinion supporting the introduction
of needle exchange programs in Canadian prisons, it is not
credible for elected and prison officials in Canada to claim that they
are unaware of the health risks associated with injection drug use in
Canadian prisons, or of the existence of a proven-effective means to
reduce those harms – namely, needle exchange programs. Despite
the support for needle exchange programs from groups and individuals
who speak with credibility and authority on the issue, governments
and prison officials in Canada have failed to take decisive
action to reduce the harms known to be associated with injection drug use, including HIV
and HCV transmission.
All of the above-noted reports are from credible sources and contain important evidence
to support prison needle exchange programs. However, three are exceptionally significant
because of the confluence of processes and people involved in the evidence gathering, production,
and publication of each.
Governments and prison
officials in Canada must take
decisive action to reduce the
harms known to be
associated with injection
drug use, including HIV and
HCV transmission.
Expert Committee on AIDS and Prisons
The 1994 HIV/AIDS in Prisons: Final Report of the Expert Committee on AIDS and Prisons
by the Expert Committee on AIDS and Prisons (ECAP) was published by the Correctional
Service of Canada. In 1992 ECAP was established at the direction of the Solicitor General
of Canada to assist the federal government to promote the health of federal prisoners and to
protect CSC staff, and to prevent the transmission of HIV and other infections within federal
correctional facilities. Committee members were a clinical immunologist, researcher, and
ethicist; a physician and member of CSC’s Health Care Advisory Committee; a social work
58 Prison Needle Exchange: Lessons from a Comprehensive Review of International Evidence and Experience