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PARLIAMENTARY GROUP

DRAFT LAW NO. 189 /X

ESTABLISHES THE IMPLEMENTATION OF A PILOT PROJECT

TARGETED FOR THE COMBAT AND PREVENTION OF INFECTIOUS DISEASES-

CONTAGIOUS IN A PRISON MEDIUM

Exhibition of reasons

Portugal, one of the countries with the lowest crime indexes in the Union

European, it hits all records in incarceration.

The overcrowding of Portuguese prisons determines, since soon, the conditions

inhumane in which they live the detainees in the prisons, subject addressed by a study of the

Ombudsman's Ombudsman, released in 2003 and bearer of a large number of proposals

to alter a situation with very troubling contours.

One of the major problems here identified is that of the infectious diseases-

contagious: Year after year, the available data on the prevalence of diseases

infectious-contagious in Portuguese prisons has been alerting us to the alarming situation

which stems in a prison half.

It tells us this report that the public health indicators in prisons are, in the

our country, alarming: 30.6% percent of inmates have hepatitis, 8.5% percent is seropositive, 2.1% percent has

AIDS. Portugal is the country of the European Union with highest percentage of people with

AIDS in prisons.

These data are reinforced by the results of a study conducted by Anaul

Torres and Maria do Carmo Gomes me 2002. Being certain that the research has had on the basis

self-filled surveys, the data collected leads the authors to admit that perhaps

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" the situation is even more worrying than the one that was clearly assumed by the

recluses " (Torres and Gomes, Drugs and prisons in Portugal , 2002: 55).

We are therefore facing a situation of extreme gravity in prisons

Portuguese. The consistency of these values with the evolution estimated by previous

studies, it can only lead to the conclusion that the strategies up to here attempted are not

produce any result. On the contrary. There appears to be a continued increase in

prevalence of infectious diseases-contagious diseases in Portuguese prisons. There is, thus, that

pressing forward urgently with new responses that can reverse this situation.

Salient further that it is not only these studies that draw attention to the

question, starting even to generate a broad consensus in Portuguese society

on the need to change the functioning of public health services in the

prisons, as proven by the statements of then deputy of PSD Jorge Nuno Sá,

in the parliamentary debate of January 24, 2003: " And how much to the reality lived in the

our chains and what goes on? Will we continue to ignore the situation? It takes, it's

fundamental, it is imperious even, to join synergies and not to be bureaucratized and

compliments the possible solutions! ", idea shared by the Deputy of PS Vitalino

Canas, who defended, in a debate held on the February 28 of the same year, the

extension of the syringes exchange programme to prisons, stressing that this media

is included in the national plan to combat drugs and drug addiction.

Transmission of infectious diseases appears strongly related

with two types of practices: "unsafe" sexual relations, and drug use by way

endovenous due to the sharing of syringes / needles. The response of the Health Service in

means of prison should thus work on these two strands-information and

provision of means that will provide security in sexual contact, and programmes of

prevention and measures of risk reduction and harm in drug use.

I-Prevention of transmission of infectious diseases-contagious: sexual relations

protected

The study of Torres and Gomes indicates also that the regular use of condoms is

reduced in the prison medium: about half of the inmates do not protect themselves in a way

systematic of the risks of transmission by sexual route, and if we present the numbers

previously pointed out of the prevalence of infectious diseases in the population

prison, this is one of the most worrisful aspects and demands immediate response.

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They are thus placing two kinds of issues. On the one hand, it is fundamental to bet

in a greater dissemination of information in a prison medium of the risks involved in the

practice of unprotected sexual relations. On the other hand, it is necessary to put to the

disposition of inmates-in easy, practical way and that does not imply constraints

or invasion of privacy-means of protection.

The April 1999 Ombudsman's report warned already for the

deficiencies found in various prison facilities in the one that touches the

regular provision of condoms, which made letter dead the provisions of the

circular n. 9/DSS/97. The flawed in the application of such simple measures, but so

fundamental, such as the distribution of condoms in prisons, warns us to

need to set up regular monitoring mechanisms, so that the rule of

distribution of two condoms by each reclusive, each week, be fulfilled without

exceptions.

Finally, the health situation in prisons and persistence over time

of risky behaviours, implies a change in the role of the DGSP, which must pass

to intervene more directly, and to assume the responsibility of producing materials from

dissemination of safe practices, and, in articulation with Ministry of Health, foster a

medical and nursing care that will also do the prevention pedagogy

primary and education for health in a prison medium. These measures, provided for in the Act

170/99 of September 18, should be expanded and extended, so that they become

actual its purposes.

II-Prevention of transmission of infectious diseases: prevention of risks

and harm reduction in injecting drug users

Much of the Portuguese prison population has been detained for direct acts or

indirectly related to drugs. In 2002, drug trafficking and the crimes that

aimed at reaching means to consume drugs are the reasons for holding about

73% of the Portuguese prison population (Torres and Gomes, op. cit. , 2002: 78).

Thus, it is certain that drug and prison detention have in Portuguese society a

strong association, what makes the drug-trafficking and consumption-a central element of the

everyday of prison vivance.

The situation is worrying even because the prevalence of continued consumption of

injectable drug in half-prison rounds round the 30%. In this segment, the risk practices

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remain: about 35% declares not always to use new needles, and about a quarter

of the inmates admits to having shared syringes in prison. If we take into account that more than

90% of those who declared themselves seropositive assumed to consume from drugs, the relationship

between seropositivity and drug use is worryingly strong.

Here it is therefore, the cycle that is necessary to break. The prevalence levels of

infectious diseases and consumption of injectable drugs in a prison medium

require that multifaceted risk reduction strategies be created. It is not acceptable

that a prison sentence can often amount to a death sentence for the

recluses.

In that sense, it is necessary to adopt a diverse set of measures. In the

essential, they all aim, on the one hand, to limit the possibilities of contagion from

infectious diseases, and, on the other hand, facilitate access and contact of the

prison population consuming drug injectable with the prison health system,

and thus, improve your health levels and possibly go forward for treatment.

First, as noted above, it is considered that the policies of

primary prevention provided for by diploma 170/99 of September 18 should be

extensively strengthened and applied in all prison establishments, so that the

examinations of frequent dispistes, access to information or distribution of

condoms are a reality.

Second, it is urgent to implement a syringe exchange system in the

prisons. The argument of the security issues that would involve a program of this

type does not withstand a caregiver analysis. As the Ombudsman said in 1999, the

problem of safety " should not be (...) fully inhibited the weighting of

solutions (...). The figures for drug addiction in prisons are worrying.

The figures, in turn, concerning the evolution of infectious diseases in half

penitentiary, are alarming. These numbers associated with the former will

necessarily of being the subject of deep reflection ".

In Spain, for example, a syringes exchange program is on

operation for several years now-according to the OEDT/2005 Report, in 2003 alone

have been distributed 18260 syringes-without putting any problem of

security. On the contrary, the adoption of different risk reduction measures and the

extended offer of treatment has allowed for currently the replacement treatments

encompass 18% of the prison population, about 82% of drug users

detained. It should be remembered, that the legislative amendment carried out in the neighbouring country was only

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approved after the realization of a pilot project and the positive evaluation of its

results. While in Portugal everything remains in the same, the new legal framework of the

Spanish state has already had a result: Portugal traded with this country to nothing enviable

position of country with the worst HIV indicators in prisons. It is then time to adopt

similar procedures in our country, and proceed to the awareness and training of the

workers of the prison system.

On the other hand, the detention situation cannot deny the rights more

fundamental " equality of citizens in access to health care, whichean is

their economic situation and wherever they live ", as indicated by the Bases Act of the

Health, which, incidentally, also establishes the need to implement " special measures

relatively to groups subject to greater risks ". Thus being, the incarceration does not

should deny the reclusion the possibility of proceeding to the exchange of syringes, such as any

another citizen.

To this syringe exchange program, it should associate with the creation of rooms of

assisted injection, where prisoners are able to make consumption under conditions of

hygiene and safety, under anonymity and accompanied by capacious technicians. The

delivery of the syringe at the entrance to the compartment, and its mandatory refund to the exit,

will allow to limit risks of aggression, and simultaneously lock the transmission by way of the

sharing of syringes

Thus, a syringes exchange program should be implemented in prisons,

associated with a pilot project aiming at the creation and evaluation of the operation of a

set of assisted injecting rooms in different establishments. In that sense, and

under the regimental standards in force, the parliamentary group of the Left Bloc

proposes:

Article 1.

(Subject)

This Act sets out the framework of operation of a pilot-reduction project

of risks to public health in prison establishments.

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Article 2.

(Scope)

The pilot-risk reduction for public health in establishments

prisms provides for the creation of assisted injection and syringe exchange rooms in a

selected set of prison establishments.

Article 3.

(Project-pilot)

1-The pilot-risk reduction for public health in establishments

prisals will be applied in four prison establishments, located at

different districts, to be determined by Portaria of the Ministry of Justice.

2-In the choice of the prison establishments referred to in the preceding paragraph will be given

priority for establishments with the highest incidence of infectious diseases and

of addictions.

3-All assisted injecting rooms created under the pilot project have

appropriate medical assistance, under a protocol to be concluded between the Ministries

of Health and Justice.

Article 4.

(Creation of assisted injection rooms)

1-Consider assisted injecting rooms the facilities where consumption is made

of narcotic drugs by intravenous, with syringe reception system at the entrance of the

compartment against its return to the exit, under conditions of sanitary control and of

hygiene.

2-A creation of assisted injecting rooms in prisons covered by the pilot project

of reduction of risks to public health is determined by the Ministry of Justice and the

application of this decision is the competence of the Ministry of Health, safeguarding the

appropriate security measures.

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Article 5.

(Conditions of use of the assisted injecting rooms)

1-Any commercial acts in the interior of the assisted injection rooms are to be seen.

2-All materials required for consumption, with the exception of substance

stupefied, are supplied to the utent in proper conditions of hygiene and, after the

consumption, stay in power of the responsible of the room.

3-The default of the room security standards by the utente impossibilit-

o to access these facilities again.

Article 6.

(Supervision of the assisted injecting rooms)

1-A supervision and monitoring of the technicians and the operation of the rooms

assisted injection are the responsibility of the Ministry of Health.

2-The infrastructures dedicated to the operation of the assisted injection rooms

they must also serve to provide information to addicts facilitating the

voluntary forwarding to treatment systems.

Article 7.

(Exchange of Seringes)

1-The Ministry of Justice coordinates the syringes exchange program in the

prison facilities, through protocols with the Ministry of Health.

2-A The exchange of syringes is free, made under anonymity and under conditions that guarantee to

reduction of risks among the addicted population.

Article 8.

(Office of support)

1-All prison establishments covered by the pilot-reduction pilot project

risks to public health have a supportive office, supervised and

accompanied by technicians from the Ministry of Health, which will coordinate the programme of

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exchange of syringes and the free distribution of condoms, ensuring respect for the

anonymity of users.

Article. 9º

(Coordination and evaluation of the pilot project)

1-The pilot project is drawn up and implemented jointly by the Ministries of Health

and of Justice.

2-A The evaluation of the pilot project is carried out two years after its start, through

of report that is submitted to the Assembly of the Republic.

3-A Parliamentary Committee of the Assembly of the Republic for the area of Health

follow up with this process and make recommendations to the tutelage.

Article 10.

(Regulation)

This diploma shall be regulated by the Government within the maximum period of 120 days.

Article 11.

(Entry into force)

This Law shall come into force on the day following the approval of the State Budget of the

subsequent year.

Palace of S. Bento, December 20, 2005.

The Members of the Left Bloc,