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

• can reach offenders who are at relatively high risk for HIV and HCV infection and act
as a gateway that links them to other appropriate health-care services, drug treatment
programs, and counselling and social services, encouraging reintegration of offenders
back into the community
• is not and cannot be a stand-alone program, and must be offered as part of comprehensive
prevention and treatment programs such as methadone maintenance, substance
abuse and addictions programs, and counselling
The Study Group issued a consensus recommendation that the CSC do the following: 260
To obtain ministerial approval in principle for a multi-site NEP [needle exchange
program] pilot program in men and women’s federal correctional institutions,
including the development and planning of the program model; and the implementation
and evaluation of the pilot program.
Standing Committee on Health
In June 2003 the House of Commons Standing Committee on Health issued its report,
Strengthening the Canadian Strategy on HIV/AIDS. The Committee is made up of members
of Parliament from all political parties sitting in the House of Commons. It heard oral testimony
and accepted written evidence from numerous groups, organizations, and individuals,
including Health Canada, Correctional Services Canada, the Canadian HIV/AIDS Legal
Network, and the Canadian Association for HIV Research. Despite the fact that the focus of
the Committee’s examination and resulting recommendations was on funding levels for the
Canadian Strategy on HIV/AIDS, the Committee recommended with respect to harm reduction
in federal prisons that: 261
Correctional Service Canada provide harm reduction strategies for prevention of
HIV/AIDS amongst intravenous drug users in correctional facilities based on eligibility
criteria similar to those used in the outside community (as per the recommendation
of the December 2002 report of the Special Committee on Non-
Medical Use of Drugs).
The Special Committee on Non-Medical Use of Drugs recommended that “Correctional
Service Canada allow incarcerated offenders access to harm-reducing interventions, in order
to reduce the incidence of blood-borne diseases, in a manner consistent with the security
requirements within institutions.” 262
In her response to the Standing Committee’s report, the Minister of Health did not directly
address this recommendation. 263
Canadian prisons (both
federal and provincial/
territorial) have a legal
obligation to provide
prisoners with access to
sterile needles.
Legal obligation to respect, protect,
and fulfill prisoners’ right to health
As examined above (see the chapter on Human Rights and Legal
Standards Relevant to Injection Drug Use, HIV, and Hepatitis C in
Prisons) there are numerous international as well as Canadian
instruments that detail the legal and ethical responsibility of
Canadian governments to provide health care, including HIV and
HCV prevention measures, to prisoners. Based on the guarantees
60 Prison Needle Exchange: Lessons from a Comprehensive Review of International Evidence and Experience