Table 9: TB and Freedom from Torture or Cruel, Inhuman or Degrading Treatment or Punishment
Examples of Human Rights Violations
- Institutional settings are overcrowded and unhygienic, making it more likely for individuals to contract TB.
- Prisoners cannot access medical treatment and care for a TB diagnosis.
- Prisoners are not screened or tested for TB.
|Human Rights Standards||Treaty Body Interpretation|
|CAT 16(1) Each State Party shall undertake to prevent in any territory under its jurisdiction other acts of cruel, inhuman or degrading treatment or punishment which do not amount to torture as defined in article I, when such acts are committed by or at the instigation of or with the consent or acquiescence of a public official or other person acting in an official capacity.||CAT: Expressing concern to Zambia at the prevalence of tuberculosis and the high contamination rate of inmates and prison officers due to overcrowding and the lack of adequate health care. Recommending that the State speed up the establishment of health care services in prisons including the recruitment of medical personnel, as established under the Prisons Act of 2004. CAT/C/ZMB/CO/2 (2008).
CAT: Urging Ethiopia to “take urgent measures to bring the conditions of detention in police stations, prisons and other places of detention into line with the Standard Minimum Rules for the Treatment of Prisoners, as well as with other relevant standards, in particular by… Improving the quality and quantity of food and water as well as the health care provided to detainees and prisoners, including … tuberculosis patients.” CAT/C/ETH/CO/1 (2011).
CAT: Expressing concern to Russia about the distressing conditions of pre-trial detention, including the prevalence of tuberculosis and other diseases, as well as the poor and unsupervised conditions of detention in IVS (temporary police detention), and SIZOs (pre-trial establishment) facilities, and recommending “Urgent consideration should be given to making a medical examination compulsory for persons when they enter IVS and SIZOs.” CAT/C/CR/28/4 (2002).
CAT: Recommending that Estonia “should provide adequate food to all detainees and improve the health and medical services in detention facilities, including by making available appropriate treatments, especially to HIV and tuberculosis infected detainees.” CAT/C/EST/CO/4 (2008).
CAT: Expressing concern to South Africa and Ukraine about the high rate of tuberculosis amongst detainees and recommending that the State should “adopt effective measures to improve the conditions in detention facilities, reduce the current overcrowding and meet the fundamental needs of all those deprived of their liberty, in particular regarding health care” CAT/C/ZAF/CO/1 (2006); CAT/C/UKR/CO/5 (2007).
CAT: Expressing concern to Georgia about the “high number of deaths reported from tuberculosis” and encouraging the State to “continue its cooperation with the International Committee of the Red Cross and non-governmental organizations with regard to the implementation of programmes related to the treatment of tuberculosis and distribution and monitoring of the medicines taken in penitentiary facilities throughout its territory.” CAT/C/GEO/CO/3 (2006).
|Human Rights Standards||Treaty Body Interpretation|
|SPT: Recommending to Paraguay and Honduras “that all prisoners should have the opportunity to be X-rayed for tuberculosis using mobile X-ray units and that treatment should commence for inmates who have tested positive. Prisoners sharing a cell with a person infected with tuberculosis should be allowed to undergo a second X-ray and the Mantoux test (for prisoners who have not been vaccinated) three months later. This procedure should be repeated periodically to prevent the outbreak of further cases.” CAT/OP/PRY/1 (2010), CAT/OP/HND/1 (2010).|
|Human Rights Standards||Case Law|
|ECHR 3 No one shall be subjected to torture or to inhuman or degrading treatment or punishment.||ECtHR: Finding a violation of Article 3 because “the applicant had to spend twenty three hours per day in an overcrowded cell”. However, the Court noted that contracting TB in detention alone would not necessarily establish an Article 3 violation and dismissed this portion of the applicant’s claim due to a lack of evidence establishing inadequate medical care for his TB. Asyanov v. Russia, Application No. 25462/09 (Jan. 9, 2013).
ECtHR: Finding a violation of Article 3 because “the applicant did not receive comprehensive, effective and transparent medical assistance in respect of his HIV and tuberculosis in detention. It believes that, as a result of this lack of adequate medical treatment, the applicant was exposed to prolonged mental and physical suffering diminishing his human dignity. The authorities’ failure to provide the applicant with the requisite medical care amounted to inhuman and degrading treatment within the meaning of Article 3 of the Convention.” Koryak v. Russia, Application No. 24677/10 (Nov. 13, 2012).
ECtHR: Finding a violation of Article 3 on account of the authorities’ failure to duly diagnose the applicant with tuberculosis and comply with their responsibility to ensure adequate medical assistance for him during his detention in a correctional colony before September 2004. Vasyukov v. Russia, Application No. 2974/05 (April 5, 2011).
ECtHR: Finding that the authorities violated their obligations under Article 3 because there was a “lack of a comprehensive approach to the applicant’s medical supervision and treatment for tuberculosis and HIV and failure to ensure physical conditions reasonably adapted for his recovery process.” Logvinenko v. Ukraine, Application No. 13448/07 (Oct. 14, 2010).
ECtHR: Finding a violation of Article 3 on account of detention conditions in a pretrial detention center (e.g., overcrowding, sleep deprivation and lack of natural light and air) and the authorities’ failure to provide timely and appropriate medical assistance to the applicant in respect of his HIV and TB infections. Yakovenko v Ukraine, Application No. 15825/06 (Oct. 25, 2007) (adapted from Human Rights in Patient Care: A Practitioner Guide, www.healthrights.am/practitioner-guide)
SR Torture (2013): Noting that compulsory detention of TB patients, as is reported in certain countries, constitutes a form of abuse in the health care setting: “Medical care that causes severe suffering for no justifiable reason can be considered cruel, inhuman or degrading treatment or punishment, and if there is State involvement and specific intent, it is torture.” Paras. 39–40. A/HRC/22/53 (2013).
Joint Statement on compulsory drug detention and rehabilitation centres (ILO et al., 2012):
Compulsory drug detention and rehabilitation centres raise human rights issues and threaten the health of detainees, including through increased vulnerability to HIV and [TB] infection…. [S]uch detention often takes place without the benefit of sufficient due process, legal safeguards or judicial review. The deprivation of liberty without due process is an unacceptable violation of internationally recognised human rights standards.