THE RIGHT TO HEALTH IN PRISON: RESULTS OF A NATIONWIDE SURVEY AND REPORT 4.42 In prisons, the Commission observed that the combination of overcrowding, poor ventilation, as well as limited access to fresh air and sunshine and the absence of early detection contributed directly to the increase in reported TB cases. In addition, the lack of a standardised screening procedure for TB has turned prisons into a breeding ground for TB. This has also lead to the transmission of the disease among prison staff, many of whom informed the Commission that they have latent TB. 4.43 The Commission takes note of the High Impact Research and study conducted by University of Malaya’s Centre of Excellence for Research in AIDS (CERiA)129 to define the size of the TB problem in Malaysian Prisons and to determine appropriate interventions to control the spread of TB in prison. The study was launched with a series of standardized tuberculin surveys in both Kajang and Pengkalan Chepa prisons, involving representative samples of prisoners and prison officers. Both sites revealed extraordinarily high prevalence of tuberculin reactivity (inactive TB) amongst prisoners and prison staff alike (88.8%, 87.6%, 80.95% in Kajang prisoners, Pengkalan Chepa prisoners and Kajang prison staff, respectively).130 4.44 Although the programme has improved timely access to proper TBrelated prevention and treatment to prisoners, as well as contributing to the improvement in the overall survival in the targeted prison (Kajang), the Commission is concerned with the sustainability of the programme. 4.45 The Commission therefore recommends that a framework and specific guidelines for the prevention and control of TB in the Malaysian prison system be developed by the Ministry of Health. The Commission also recommends that these guidelines include persons working in prisons, as well as for a compulsory screening procedure to be in place to screen all prisoners and detainees upon entry. (iii) Vulnerable Populations in Prisons Foreign National Prisoners 4.46 While the Commission notes that in general, all prisoners receive the same medical treatment and services, it was informed that treatment for HIV/ AIDS (anti-retroviral medication) is prioritised for Malaysian prisoners UM HIR SPECIAL FEATURE (15th May 2014) accessed via http://hir.um.edu.my/?modul=artikel&pilihan=papar&id=2576 on 23/2/16. 130 Ibid 129 72