World

Health Organization

Message from chairperson

Dear Delegates,

Welcome to the World Health Organization! First, a little about myself. My name is Ishaan
Srivastava. Im a 16 year old student in Year 11 at the Dhirubhai Ambani International
School (DAIS). SISMUN 2016 will be my 16th MUN Conference, and my 6th as a member
of the Executive Board. Your Vice President, Sharvil Desai, is a Year 11 student too at the
Singapore International School.

At SISMUN this year, we will be focusing on "to use all existing R&D concerning the
development of AIDS and Ebola vaccine as state shared resources" and "hygiene
conditions in women prison wards". The first topic is very interesting in the sense that
research and development that firms have been working towards for years now is being
looked at as something that will come under public property. Is this more efficient? Will
this ensure more economical prices for the product outcomes of this research? The
second topic, however, is more grave and recognizes that harsh reality of today's prisons
for women. Agreed that they are criminals but that clearly does not allow the modern
democracies to deprive them of their human rights.

To tackle these issues, delegates will have to be well versed in the intricacies of not only
international politics, but also moral and modern technology and financial stances that
have contributed to the current situation. As your Chair, I expect you to understand that
this topic is anything but one-dimensional and requires a great level of analysis.

I hope to see well researched delegates, each eager to prove his or her point and defend
their respective stance and please feel free to contact me at
ishaan.srivastava99@gmail.com or your vice chair, Sharvil, at sharvil_99@hotmail.com.

Yours faithfully,
Ishaan Srivastava,
Chair of WHO.

Introduction to the committee

At this years edition of SISMUN, we will be simulating the World Health
Organization. It is a specialized agency of the United Nation that is concerned with
international public health. Since its creation, it has played a leading role in
the eradication of smallpox. Its current priorities include communicable diseases, in
particular HIV/AIDS, Ebola, malaria and tuberculosis; the mitigation of the effects of
non-communicable diseases; sexual and reproductive health, development, and aging;
nutrition, food security and healthy eating; occupational health; substance abuse; and
reporting, publishing, and spreading information about diseases and their cures.
The principles the WHO follows and the principles its mandate is based on are as
follows:
a) Health is a state of complete physical, mental and social well-being and not
merely the absence of disease or infirmity.
b) The enjoyment of the highest attainable standard of health is one of the
fundamental rights of every human being without distinction of race, religion,
and political belief, economic or social condition.
c) The health of all peoples is fundamental to the attainment of peace and security
and is dependent on the fullest co-operation of individuals and States.
d) The achievement of any State in the promotion and protection of health is of
value to all.
e) Unequal development in different countries in the promotion of health and
control of diseases, especially communicable disease, is a common danger.
f) Healthy development of the child is of basic importance; the ability to live
harmoniously in a changing total environment is essential to such development.
g) The extension to all peoples of the benefits of medical, psychological and related
knowledge is essential to the fullest attainment of health.
h) Informed opinion and active co-operation on the part of the public are of the
utmost importance in the improvement of the health of the people.
i) Governments have a responsibility for the health of their peoples, which can be
fulfilled only by the provision of adequate health and social measures.
With regard to procedure, the Executive Board will recognise two forms of
paperwork in committee: a resolution and a directive.
Most of you will be familiar with the contents and structure of a resolution, and as
such, it will not be elaborated upon. A Directive, in comparison, enables the committee
to take affirmative action. It allows the committee to use the resources available from
different nations, upon their approval, to achieve the aims and goals set forth by the
committee. The nature of these resources vary from situation to situation. Directives are
very specific and usually technical in nature. The ideal directive would specify:
The action and the nature of the action that has to be taken.


The specific mission of the action.

The number of resources required for the action.

Which member nations are providing the resources and how the funding of the

resources is to be carried out.

History of the Committee

The World Health Organization (WHO) is the agency in the United Nations
(UN) charged with the responsibility of planning and coordinating wellbeing. The
origins of the WHO can be traced back to the Worldwide Sanitary Conference, which
was the principal significant meeting that talked about open wellbeing on a global level,
held in Paris in 1851. While the subjects talked about at this beginning meeting were
very slender, it resulted in the establishment of the WHO. After the creation of the UN,
delegates of 51 Member States went to the International Health Conference in 1946 and
endorsed the constitution of the WHO. The constitution did not go into power until two
years on 7 April 1948. World Health Day is presently observed every year on the 7th of
April in remembrance. Article 57 of the Contract of the United Nations states that "the
different specific organizations, built up by intergovernmental assention and having
wide universal obligations, as characterized in their fundamental instruments, in
financial, social, instructive, wellbeing and related fields, might be carried into
association with the United Nations." This implies, as the UN organization mindful for
wellbeing, WHO coordinates with the General Assembly and the Economic and Social
Council. WHO reports to the ECOSOC, as ECOSOC is the body enabled to organize
and coordinate particular organizations.
The World Health Assembly (WHA) comprises delegates from the 194 UN
Member States. WHA is the fundamental choice making body of the WHO and
concentrates on particular themes suggested by the Executive Board. Delegates of the
WHA are, by and large, high-positioning authorities from their particular services or
branches of wellbeing, giving an abnormal state of specialized and concentrated
learning to the association. The Executive Board (EB), conversely, comprises 34
exceedingly prepared and qualified delegates chosen from the Member States. The
essential part of this board is to prompt and encourage the work of WHA. WHA and EB
give direction to the WHO; everyday operations are carried out at the WHO central
station, territorial workplaces, and nation workplaces.

The WHO consists of its home office in Geneva, six provincial workplaces, and
more than 150 national workplaces. Every level of representation covers a particular
geographic zone and permits the WHO to give specialized counsel at all levels. WHO
gives a lot of its backing through the national level workplaces as they have solid

associations with the wellbeing contraption in the individual Member States. The part of
the WHO has changed after some time, with the WHO executing programs in the initial
two decades, including a push to annihilate intestinal sickness. The WHO implements
extensive programs at various levels, be it regional, national, or international, and also
ensures that it issues sufficient advice and warning to Member States.

Topic A: To use all existing R&D concerning the

development of AIDS and Ebola vaccine as state
shared resources
AIDS
The world has changed fundamentally post the Millennium Development Goals
and the 2001 Declaration of Commitment on HIV/AIDS. In the wake of the financial
emergency in certain regions, systems have modified and adapted. Developing financial
nations are doing their best to level the developed nations. Totalitarianism has been
supplanted with noteworthy and supported development over large parts of Africa. In
this quickly evolving setting, the worldwide HIV epidemic reaches a crucial point,
where the advancements of the past may not be sufficient and current techniques are
reaching their limits. In 2009, an expected 2.6 million individuals were tainted with
HIV, and 1.8 million individuals died. One third of the 15 million individuals living
with HIV in need of treatment are actually receiving it. New contaminations keep on
outpacing the quantity of individuals beginning treatment, while the upward pattern in
assets level plateaued in 2009. The lifestyle of those living in the South, including those
of common society and individuals living with and influenced by HIV, does not
facilitate a fight against HIV and its spread. The future costs that HIV forces on
individuals, families, groups and nations will be controlled by how national and
worldwide accomplices reposition the HIV efforts to influence the movement. Striking
measures are called for, and the present patterns can bring these measures about. In spite
of the fact that new HIV contaminations are declining and the quantity of individuals
getting antiretroviral treatment is developing, starting 2013, 35 million individuals were
all the while living with HIV. The focal point of the pestilence remains sub-Saharan
Africa, home to 70% of all new HIV infections. Diseases, such as HIV/AIDS, can be
detrimental to a nation by significantly lowering productivity and GDP. Youngsters
who lose their parent(s) to AIDS are more helpless against abuse, teachers contaminated
with HIV can't instruct viably, and soldiers with HIV/AIDS will most likely be unable
to ensure their nations safety. The Millennium Development Goals (MDGs) are eight
worldwide improvement objectives that were set up after the Millennium Summit of the
United Nations in 2000, after the reception of the United Nations Millennium
Declaration. Every one of the 189 United Nations part states at the time (there are 194

right now), and no less than 23 global associations, resolved to accomplish the
following Millennium Development Goals by 2015:
1. To annihilate compelling destitution and hunger

2. To accomplish all-inclusive essential training

3. To advance sexual orientation balance and enable ladies
4. To lessen infant mortality
5. To enhance maternal wellbeing
6. To battle HIV/AIDS, jungle fever, and different illnesses.
7. To guarantee natural maintainability
8. To build up a worldwide association for improvement.
Keeping in mind the end goal to battle HIV and AIDS and so forth three
objectives were conceived which were to be met by 2015
1. Have ended by 2015 and started to invert the spread of HIV/AIDS
2. Accomplish, by 2010, general access to treatment for HIV/AIDS for every one of
the individuals who need it
3. Have stopped by 2015 and started to switch the occurrence of jungle fever and
other significant infections. At the end of 2013, 35 million individuals were
living with HIV.
That same year, somewhere in the range of 2.1 million individuals turned out to be
recently contaminated. Nearly 12 million individuals in low/medium salary nations
were getting antiretroviral treatment toward the end of 2013. More than 66% of new
HIV contaminations are in sub-Saharan Africa. As the world moves towards the
deadline for the Millennium Development Goals, WHO is working with nations to
execute the Global Health Sector Strategy on HIV/AIDS for 2011-2015. WHO has
recognized six operational goals for 20142015 to bolster nations most effectively in
moving towards the worldwide HIV goals. These are to bolster:
Vital utilization of ARVs for HIV treatment and anticipation;
Disposal of HIV in youngsters and extending access to pediatric treatment;
An enhanced wellbeing division reaction to HIV among key populaces;
Advancement in HIV counteractive action, determination, treatment and care;
Key data for viable scale up; and
More grounded connections in the middle of HIV and related wellbeing outcomes.
WHO is a cosponsor of the Joint United Nations Program on AIDS (UNAIDS).
Inside UNAIDS, WHO drives exercises on HIV treatment and care, HIV and
tuberculosis co-contamination, and together organizes with UNICEF the work on the
end of mother-to-child transmission of HIV. UNICEF coordinates its endeavors in a few
key regions to battle this pandemic, the first being counteractive action. More than 2
million youngsters under 15 are tainted with HIV, and 15 to 24-year-olds represent a
sizeable portion of all new HIV diseases in 2003. With government and common
accomplices, UNICEF diminishes juvenile dangers and helplessness to HIV/AIDS by
expanding access to relevant medical equipment and technology and helps coordinate
compartmentalization of data on such diseases. For instance, UNICEF sorts out data

crusades on HIV/AIDS aversion and treatment, and expands youngsters' entrance to

youth-accommodating, wellbeing benefits that give deliberate testing and guidance,
particularly in nations influenced by emergencies. UNICEF additionally bolsters
activities of governments in anticipating guardian to-kid transmission of the infection.
In 2004, 640,000 children were tainted with the HIV infection either amid their mother's
pregnancy, conception or through breastfeeding. Pregnant women with HIV can
minimize the possibility of transmitting the disease to their children if they have access
to antiretroviral drugs. UNICEF fortifies government abilities to guarantee that both
women and children receive ARV treatment. As a major aspect of this exertion,
UNICEF, the WHO and UNAIDS propelled the '3 by 5' activity in 2003, which
intended to guarantee that 3 million individuals had access to retroviral treatment before
the end of 2005. It supplemented the work of government benefactors, universal
organizations and pharmaceutical organizations to lessen prescription costs and expand
treatment access. UNICEF additionally advances guidance on breastfeeding techniques
so that each guardian influenced by HIV/AIDS knows how to limit and prevent its
transmission to newborns. In 2010, the quantity of youngsters infected by AIDS in subSaharan Africa surpassed 18 million. In addition to being more defenseless against lack
of healthy sustenance and illness, members of the homeless population will probably
fall behind or drop out of school. UNICEF advances family, group and national projects
that help families and kids who have lost one or both parents to HIV/AIDS. These
incorporate education, wellbeing administration, psychosocial support, and wellbeing
services.

Ebola
Ebola Virus Disease (EVD) was initially recorded in 1976 through two
synchronous episodes in the Democratic Republic of Congo close to the Ebola River,
from which the infection receives its name, and in Sudan. The infection is lethal,
resulting in death for roughly 90% of those tainted. Variety Ebola virus is one of three
"individuals" of the filo virus family and has five distinct species/strands:
- Bundibugyo Ebola virus (BDBV)
- Zaire Ebola virus (EBOV)
- Reston Ebola virus (RESTV)
- Sudan Ebola virus (SUDV)
- Ta Forest Ebola virus (TAFV)
The BDBV, EBOV, and SUDV have been responsible for the deadly episodes
inside of Africa, while the RESTV species (frequently found in the Philippines and in
China), have tainted people, yet have not brought about reported ailment or passing.

Transmission
Ebola is transmitted from human to human by close contact with organic liquids,
for example, blood and semen, or contaminated creatures. Men who have been tainted
with the malady and survive can still transmit Ebola through their semen up to seven
weeks in the wake of recuperation. Inside Africa, acute levels of transmissions are
recorded because of taking care of sick or deceased chimpanzees, gorillas, fruit bats,
monkeys, impalas, and porcupines found inside of the rainforest. The breeding time of
Ebola (from contamination to observation of symptoms) is between 2-21 days.
Symptoms generally present as sudden fever, muscle torment, cerebral pain and sore
throat. As the infection increases, the infected individual will experience vomiting,
diarrhea, rashes, failing kidney and reduced liver capacity. Different testing systems
exist to analyze the malady; in any case, getting tested is viewed as a possible hazard
and should be conducted under only certain conditions

EffectsAIDS-
HIV/AIDS is an overall pandemic. By 2012, about 35.3 million people had HIV
worldwide with the amount of new infections that year being around 2.3 million. Of this
infected population about 16.8 million are women and 3.4 million are under 15 years
old.
HIV/AIDS impacts the monetary matters of both individuals and countries. The
aggregate national yield of the most affected countries has decreased due to the
nonattendance of human capital. Without support, human administrations and
pharmaceutical equipment, people suffering from AIDS are unable to function correctly
or be part of the workforce. Returning to work is troublesome, and infected individuals
may not have the same productivity they had prior to infection. Other problems
associated with infected unemployed people are memory issues and social separation;
It is the opinion of various organisations and think tanks that the loss of
productivity due to infection by AIDS is resulting in a growing burden on a given state's
assets and is reducing the growth of the economy.

Ebola-
Outbreaks of the disease can generally be traced to tropical districts of SubSaharan Africa. From 1976 (when it was initially discovered) through 2013, the WHO
has reported 1,176 cases. The biggest episode to date is the ongoing 2014 West Africa
Ebola infection flare-up, which significantly affected Guinea, Sierra Leone and Liberia.

2014 to 2015 West African outbreak

Increase over time in the cases and deaths during the 20132015 outbreak

In March 2014, the WHO reported a noteworthy Ebola episode in Guinea, a

western African country. Scientists traced the episode to a one-year-old toddler who
died December 2013. The sickness then quickly spread to the neighboring nations of
Liberia and Sierra Leone. It is the biggest Ebola flare-up ever reported. On 8 August
2014, the WHO pronounced the scourge to be a universal general wellbeing crisis.
Asking the world to offer aid to the infected districts, the Director-General said,
"Nations influenced to date just don't have the ability to deal with an episode of this size
and many-sided quality all alone. I ask the universal group to give this backing on the
most critical premise conceivable." By mid-August 2014, Doctors Without Borders
reported the circumstance in Liberia's capital Monrovia as "disastrous" and "breaking
down every day". They reported that reasons for alarm of Ebola among staff individuals
and patients had closed down a great part of the city's health framework, leaving
numerous individuals without treatment for different conditions. In a 26 September
articulation, the WHO said, "The Ebola epidemic ravaging parts of West Africa is the
most severe acute public health emergency seen in modern times. Never before in
recorded history has a biosafety level four pathogen infected so many people so quickly,
over such a broad geographical area, for so long."

Research and Development

WHOs Initiative for Vaccine Research (IVR) facilitates vaccine research and
development (R&D) against pathogens with significant economic burden and high
mortality rate, with a particular focus on low and middle-income countries. The
activities span the following areas:
Facilitation of early stage R&D in disease areas with no available vaccines or suboptimal vaccines,
Research to optimize public health impact where existing vaccines are
underutilized,
Research to aid introduction decision-making and post-licensure assessments of
risk/benefit
Research to improve monitoring and evaluation of vaccines in use in
immunization programmes.

IVR activities align with the strategic objective 6 of the Global Vaccine
Action Plan Country, regional and global research and development innovations
maximize the benefits of immunization, and with the fifth goal of the Decade of
Vaccines Develop and introduce new and improved vaccines and technologies.

AIDS
HIV vaccine development
Background and challenges
AIDS vaccine development is complex. First attempts to develop a vaccine
against HIV in the late 1980s were based on eliciting an antibody response, which is
how most vaccines are thought to work. However, because HIV mutates rapidly, and
its outer spike protein conceals itself from the immune system, creating the
appropriate viral antigens to use in a vaccine proved remarkably difficult, and the
approach was abandoned. More recently, many scientists believe that an AIDS
vaccine candidate will provide robust protection against HIV infection only if it
engages both arms of the adaptive immune system, i.e. cell-mediated and antibodybased immune responses.
HIV vaccine development is complicated by the incredible variability of the
virus, and in particular its envelope protein at both the individual and population
level. Thus, the evolving number of virus subtypes and recombination renders
vaccine development targeting the viral envelope constituents very difficult.
Consequently, vaccines may have to be carefully adapted to the virus forms in
circulation in the precise location where their use is intended.

Clinical trials
Encouragingly, data from the first HIV vaccine trial to show a positive protective
signal was released in 2009. The trial, termed RV 144, was performed in Thailand. It
used a combination of two vaccines in a heterologous prime-boost paradigm, i.e. one
vaccine given in four doses was then "boosted" by two doses containing both
vaccines. Analysis of the trial showed that the group receiving the vaccine had an
infection rate 31.2% lower than the group that received the placebo. Although this
result is not enough to qualify the vaccine for licensure, RV144 has provided very
useful pointers for a way forward. Several trials are planned incorporating lessons
from RV 144. If the required efficacy can be shown in any of the trials, an
HIV/AIDS vaccine could become available by 2020.
The role of WHO
The Initiative for Vaccine Research (IVR) works through the joint WHO-UNAIDS
HIV Vaccine Initiative to accelerate the availability of a safe, effective and
affordable HIV vaccine as follows:
Building international consensus, inter alia, on: methods to evaluate the safety and
immunogenicity of vaccine candidates; endpoints to determine clinical efficacy;
standards for vaccine evaluation and quality control; clinical trial design, clinical
development plans and regulatory pathways; target product profiles; and research
ethics and community participation in biomedical HIV prevention trials.
Building the capacity of regulatory agencies in disease endemic countries to
evaluate HIV vaccine-related submissions for clinical studies and eventually
licensure.
Supporting HIV high burden countries to define a national strategy for the
evaluation of, and access to new HIV vaccines.
Assuring that HIV vaccine clinical trials collect all information necessary for a
future WHO policy recommendation.

Ebola Timeline
In August 2014, a specialist board met representatives of the WHO and
decided that if certain conditions were met, it was acceptable to offer problematic
intercessions as potential medications or for aversion of Ebola infection
contamination.
On September 4-5 2014, WHO united specialized specialists to audit and
assess the ebb and flow condition of advancement of medications for Ebola infection
illness (treatments and immunizations) and also to concur the general goals for an
arrangement for assessment and utilization of potential intercessions. Another master
meeting was called for on 29-30 September 2014 to facilitate examine the potential
Ebola immunization competitors.

On 23 October, 2014 an abnormal state meeting on Ebola immunization, with

regard to financing, took place. The meeting assembled high-positioning authorities
from numerous legislatures everywhere throughout the world. The motivation behind
the meeting was to address prioritization of the Ebola antibodies; learn the amount of
immunization that would be required, where and when it would be accessible; talk
about clinical studies and how and when it would be realized that the antibodies
would work; and figure out who might fund immunizations and inoculation
programs.
Amid the 23 October meeting, Ebola antibody trials in Sierra Leone and
Liberia were displayed by NIH and CDC. No arrangements existed for Guinea,
which prompted the quick sorting out of the Guinea Working Group, a coordination
and choice-making instrument open for any individual who needed to partake. The
Consortium for the Ebola Vaccine trial in Guinea was later shaped, comprising the
Norwegian Institute of Public Health (NIPH), Ministry of Health Guinea, WHO,
MSF and Epicenter.
The promising aftereffects of the Guinea Ebola antibody trial distributed in
July 2015 demonstrated that clinical trials should be possible even under the
troublesome circumstances of a plague. This has been made conceivable by a joint
effort of an extensive variety of accomplices from controllers to specialists by means
of governments, pharmaceutical organizations, financing offices and NGOs; and
powered by a solid political will.
The Study Steering Group (SSG) for the Guinea Ebola antibody trial needs to
record

The composed endeavors by all colleagues and consortia who added to

clinical advancement of Ebola antibodies, diagnostics and medicines, in the period
August 2014 until November 2015

The wide worldwide community oriented procedure, from the first gatherings
in October 2014 by means of the distribution of the break results from the Ebola
immunization trial in Guinea on 31 July 2015 until the ideally last instances of Ebola
viral illness saw in November 2015.
It is imperative to archive the procedure from start, outline, accomplices,
association, decision of immunization and field site, execution, utilization of assets,
the part of controllers, morals panels to depict the elements basic for finishing this in
a much shorter time than regular. It ought to gather data from key sources, including
delegates from Guinea.

Vaccines

As of right now, at least 15 different vaccines are being produced (in North
America, Europe, Russia and China), with four fundamental applicants in differing

propelled phases of human testing. These incorporate the two most progressive
VSB-EBOV and ChAd3-ZEBOV and also feature a prime-support regimen of
Ad26-and MVA-EBOV created by Johnson and Johnson and a recombinant
molecule made of EBOV glycoprotein delivered in a creepy crawly cell line, created
by the biotech organization Novavax.
The two lead immunization hopefuls began human clinical trials in September
2014 and information on their health and immunogenicity profiles were prepared by
December-January. WHO assumed a key part in this endeavour, by distinguishing
and planning various trial patrons to test the immunizations in the US, Canada, and a
few nations in Europe and Africa.
These two vaccines are currently in Phase II/III trials in the three influenced
nations. The trial coordinated efforts in progress are: a ring inoculation trial of VSVEBOV in Guinea, sorted out through a huge global consortium including WHO,
MSF, Canada, Norway and colleges in the UK, Switzerland and the US; and a bunch
based, non-blinded, separately randomized trial of VSV-EBOV in Sierra Leone
under a Sierra Leonean-US-CDC joint effort. A Phase II trial of both immunizations
was completed in Liberia under a Liberian government US-NIH joint effort. This
trial was finished toward the end of April, and it is not known whether trials in
Liberia will proceed. Meanwhile, stage II trials of the GSK immunization are slated
to begin in Cameroon, Ghana, Mali, Nigeria and Senegal in the second 50% of 2015.
Pharmaceutical organizations building up the vaccines have resolved to
increase creation limit if there should be an occurrence of demonstrated
immunization viability and the need for development.

Sources
1. The world health organisation official website-
http://www.who.int/en/
2. AIDS-
http://www.unicef.org/mdg/disease.html

http://www.unaids.org/sites/default/files/en/media/unaids/contentassets/documents/u
naidspublication/2010/JC2034_UNAIDS_Strategy_en.pdf

3. Ebola-
http://www.who.int/csr/disease/ebola/en/

B: Hygiene conditions in women prison

wards
Introduction
Hygiene refers to conditions and practices that help to maintain health and
prevent the spread of diseases. Medical hygiene therefore includes a specific set of
practices associated with this preservation of health, for example environmental
cleaning, sterilization of equipment, hand hygiene, water and sanitation and safe
disposal of medical waste.
The enjoyment regarding the most noteworthy feasible standard of physical and
mental health is a central human right of each person without segregation. Be that as it
may, prisoners endure a lopsided weight of wellbeing issues as their wellbeing needs
are frequently dismissed. The United Nations (1990) Basic Principles for the Treatment
of Prisoners set out that "prisoners shall have access to the health services available in
the country without discrimination on the grounds of their legal situation" (Principle 9,
A/RES/45/111).
In this context, increased efforts are required to ensure a health promoting prison,
which is described as having the following elements:
a) Health services are equivalent to what is provided in the country as a
whole;
b) The risks to health are reduced to a minimum; and
c) That the dignity and human rights of every prisoner are respected.
All prisoners are profoundly influenced by the conditions of their confinement,
from the measure of light they get to the nature of the sustenance and cleanliness of
cells. Yet pretty much as a few conditions or hardships can be more regular among
specific gatherings, others encounter the same conditions in distinctive ways. Such is
the situation for women.
In 2008, the UN's free master on torment increased present expectations for
women by affirming that, in the connection of confinement, poor conditions can
influence them all the more unfavourably, contrasted with men. All through 2013,

research among women in jails and jail groups in five altogether different nations Albania, Guatemala, Jordan, the Philippines and Zambia discovered numerous samples
of this (and especially in the numerous dirty and risky police cells used to keep women
on capture) to have a hurtful if not crushing impact.
The instance of police care in Zambia highlights this horrendously. Women here
are mortified, as they need to visit the latrine with a male watch and having this
solicitation allowed or denied as a "benefit" for 'good behaviour' and their disgrace
and intimidation at utilizing the latrine in front of jail staff or prisoners. Others have
been denied contact with family and, by augmentation, access to sustenance, cleanliness
items or data. At times police purposely secluded ladies from outside help, including
sustenance, to pressure them into sex.
On life in jail for the most part, the most well-known protests crosswise over five
nations were about cleanliness and space. Around only 50% of the offices gave heated
water to free, and few gave free cleaning materials, as obliged by universal norms. In a
few nations, for example, Guatemala and Zambia, women are not being given any free
cleanliness things at all by the jail, including cleanser. They depicted the insults to their
essential human respect as they battle to keep themselves clean amid monthly cycle.
In many nations, it is more outlandish for women in jail than men to have access
to finances of their own, yet they have a tendency to be bolstered less by pariahs as
well, unless NGOs and other help bunches fill in. Yet none of the penitentiaries want to
give normal free supplies of sterile towels, abandoning a few women to utilizing
clothes, others expecting to source them wherever conceivable. Numerous new moms
are come back to jail inside of a day, if not hours of conceiving an offspring. The
requirement for them to effectively look for boiling hot water and cleanser, at the
absolute minimum, is despicable, damaging and obviously hazardous.
In these conditions women are frightened, liable and defenseless. In a few
detainment facilities, kids don't get their own sustenance proportions, and mothers must
share. For mothers with HIV, who require certain measures of nourishment to take their
drug, this is deadly. In a jail where two mother-and-infant sets might share a solitary
dirtied bedding, a detainee (from the Zimbabwe prison) said, " You should smell the
stench. All the kids are sick with diarrhoea, and youve got this stench coming from the
toilet, and someone sleeping with a baby next to it.
In the mean time in Jordan, where offices were moderately modern, one
component the absence of ventilation had led to specific wellbeing issues. Since

drying clothing was troublesome, urinary tract diseases had become normal, yet NGO
labourers say that numerous cases go untreated in light of the fact that ladies are
frequently excessively embarrassed, making it impossible to report them. As per a
report issued by an NGO which looks after womens health, there are rights and worries
that are exceptional to ladies that stay inconspicuous or unaddressed in light of this.
Since 2010 the UN's Bangkok Rules have tended to these issues and helped to a
great extent develop the sexual orientation blind security given by the first Standard
Minimum Rules for detainees. What's more, there are obviously jails that are confining
women in noble, low security and rehabilitative conditions as found in Albania's
fundamental jail for women. These guidelines, and these best practices, should be better
spread and utilized for change.
The UN human rights settlement bodies regularly express worry about states of
confinement in their closing perceptions to States, and once in a while with regard to
locations of women's specific conditions. Yet women remain subjectively and
quantitatively poor, with almost no reference to the Bangkok Rules or the specific needs
and vulnerabilities that they address. It is up to everybody, especially the UN
framework and jail frameworks around the globe, to wind up a champion for the
Bangkok Rules.

WHO and Europe

The European Region is the main WHO locale with a prison health program. The
Partnership for Health in the Criminal Justice System is a first-of-its-kind stage for data
spread, systems administration and aims to achieve great work on partaking in the zone
of prison health. With commitments from accomplices speaking to the principal regions
of the field, the stage will be an essential asset for strategy producers, specialists and
individuals from people in general keen on prison health.
As members of the Partnership for Health in the Criminal Justice System,
WHO/Europe and its partners share the following aims:
To encourage cooperation and establish integrated work between public
health systems, international nongovernmental organizations, and prison health
systems to promote public health and reduce health inequalities;

 To encourage prisons to operate within the widely recognized international

codes of human rights and medical ethics in providing services for prisoners;
To help reduce the number of reoffending prisoners by encouraging prison
health services to contribute fully to each prisoner's rehabilitation, especially but not
exclusively in relation to drug addiction and mental health problems;
To reduce prisoners' exposure to communicable diseases, thereby preventing
prisons from becoming focal points of infection;
To encourage all prison health services, including health promotion services,
to reach standards equivalent to those in the wider community;
To promote a whole-of-government approach for the management and
coordination of all relevant agencies and resources contributing to the health and
well-being of prisoners; and
To encourage health ministries to provide and be accountable for health care
services in prisons and advocate healthy prison conditions.

Major problems
In general, the prison populations in Europe come from the sections of society
with high levels of poor health and social exclusion. Prisoners tend to have poorer
physical, mental and social health than the general population. Their lifestyles are more
likely to put them at risk of ill health. Many prisoners have had little or no regular
contact with health services before entering prison. Mental illness, drug dependence and
communicable diseases are the dominant health problems among prisoners. Prisons
should regularly assess the needs of their populations to ensure that health promotion
and prevention programmes accurately address the needs of all prisoners.

Frame of Reference
Obviously, prison systems vary from country to country and even from region to
region. As such, it becomes necessary to develop standards to measure the quality of a
prison by, and thereby determine how well it maintains hygienic conditions of living.
The quality of primary health care in prison depends on many factors:
the total resources available to the prison system;
the state of development of primary health care in the community,
including entitlement to dental, pharmacy and clinical investigation
resources; and
the development of mental health care in the community.

In this regard, the Standard Minimum Rules for the Treatment of Prisoners also
comments on the role of health care. It states that:
Health care professionals should be educated, aware and demonstrate high
standards of hygienic practice; capable of assessing cleanliness of patients and all prison
facilities; and aware and capable of operating effective tuberculosis control, including
auditing results.
Effective control procedures are needed to limit the transmission of blood borne
viruses and sexually transmitted diseases.
There should be a smoking control policy for health centres, prisoners and staff
across the prison.
Methods of reviewing critical incidents should be in place for key events such
as deaths in custody, deaths following custody, suicide prevention programmes and
people with serious mental illness.
If all these methods are implemented and these principles are followed, there will
be an overall increase in quality of hygiene in womens prisons, and this will in turn
cause an increase in quality of healthcare available in a given womens prison. In this
particular case, the focus is on womens prisons as women have slightly more advanced
needs than those of men, in terms of hygiene and general wellbeing.
Another issue to focus on is womens sanitary supplies. In prisons worldwide,
there is an acute shortage of essential hygiene products. This shortage can be caused due
to various reasons. In one situation, it could be caused due to a lack of availability or
supply. In another, it could be brought about by the fact that the products are too
expensive for most of the prison population to afford. In England, there are reports that
guards refuse to provide the prisoners with the products, as a way to assert their
dominance. All member nations should come together and ensure that such actions do
not take place in the future.

Importance of Gender-Specific Healthcare

Women in prison often have more health problems than male prisoners. As
indicated by various studies, many have chronic and complex health conditions
resulting from lives of poverty, drug use, family violence, sexual assault, adolescent
pregnancy, malnutrition and poor health care (Canadian HIV/AIDS Legal Network,
2006; WHO Regional Office for Europe, 2007a). Drug-dependent women offenders
have a higher prevalence than male offenders of tuberculosis, hepatitis, toxaemia,

anaemia, hypertension, diabetes and obesity (Covington, 2007). Mental illness is

overrepresented among women in prison, as 80% have an identifiable mental disorder.
Two thirds have post-traumatic stress disorder (Zlotnick, 1997) and two thirds a
substance-related disorder (WHO Regional Office for Europe, 2007b). The frequency of
comorbidity is substantial. Mental illness is often correlated with prior victimization
(Zlotnick, 1997). Womens prisons require a gender-specific framework for health care
that pays special attention to reproductive health, mental illness, substance use problems
and physical and sexual abuse. Timely access to all services available for women
outside prison should be available for women inside prison. As with all prisoners,
confidentiality of medical records should always be guaranteed.
Women in prison in western Europe tend to request more health services than
men. For instance, in Italy, women in prison ask to see a physician or nurse about twice
as often as men in prison (Zoia, 2005). This ratio might be even higher in other western
European countries. Among the reasons for their higher demand for health services are
their higher needs for care related to a history of violence and abuse, drug use problems
and reproductive needs.
Some of the specific needs of women in prison should be tackled by taking
advantage of the time they are in prison to provide education about preventing illness
and maintaining good health, especially HIV and other sexually transmitted infections.
Further, vocational and job training programmes should be offered.
As a result of the chaotic lifestyles of many of the women who enter prison,
their time in prison may be the first time in their life they have access to health care,
social support and counseling. Information, prevention and screening programmes for
women in prison are therefore essential, and particular attention should be given to
different groups of women and their specific needs (Zoia, 2005). An even better option
would be to screen the women on entering prison and, if appropriate, send them out to
special programmes offered in the community.
Womens specific health care needs are often unmet in prison. The prison
environment does not always take into account the specific needs of women, such as
accessibility to regular showers, the greater need for personal care products due to
menstruation, the need to make sanitary napkins and the like available free of charge
and to dispose of them properly and adequate nutrition for pregnant women and for
women with such diseases as HIV. Womens normal human functions, such as
menstruation, reproduction and the need for exercise, are too often medicalized. For
example, health care personnel do not need to approve or manage access to sanitary
napkins and the like or exercise for healthy women.

Relevant Documents
The Kyiv Declaration on Womens Health in Prison
This document stated that:
The prison environment does not always take into account the specific needs of
women. This includes the need for adequate nutrition, health and exercise for pregnant
women and greater hygiene requirements due to menstruation such as the availability of
regular showers and sanitary items that are free of charge and may be disposed of
property.
Additionally, the UNODC, in collaboration with the WHO, laid down standards
for what it referred to as a gender-sensitive health care system. They issued a
document which declared that:
A gender-sensitive health care system in prisons should reflect the special health
care needs of women in prison by providing appropriate facilities and regimens and by
allowing easy access to health and social support services necessary for women.
The services should be based on primary care that takes a holistic approach in
assessing these needs and offers a range of services, including health promotion
emphasizing self-care, nutrition and exercise, preventive screening services similar to
those available in the local community and advice and help in day-to-day health
problems.
The primary services should be able to cope with many of the more complex
health needs, the complex problems and reproductive and sexual health needs of women
in prison, through additional training of the health team and their ability to access
specialist help. This should include primary mental health support and access to therapy
to help to process trauma and to promote the well-being of women with histories of
abuse.
The prison health services need to be aware of and prepared to meet the specific
needs of girls and older women in prison.
The health service should be involved with the other staff members who meet
needs for rehabilitation and reintegration through services specially designed for
women.

Sources
http://www.who.int/topics/prisons/en/
https://www.opendemocracy.net/jo-baker/women-in-prison-particular-impact-ofprison-conditions
http://www.euro.who.int/__data/assets/pdf_file/0004/76513/E92347.pdf?ua=1
http://www.euro.who.int/__data/assets/pdf_file/0009/99018/E90174.pdf?ua=1
http://www.who.int/hhr/JC2310_joint_statement_20120306final_en.pdf?ua=1