Health, Human Rights, and the Transformation of Punishment: South African Litigation toaddress HIV and Tuberculosis in Prisons

摘要

South Africa experiences the world’s highest HIV burden and one of the highest burdens for tuberculosis(TB). People in prison are particularly vulnerable to these diseases. Globally, and internally in SouthAfrica, increased attention is being paid to HIV and TB treatment and prevention in prisons, with thepublic health community arguing for reforms that improve respect for the human rights of incarceratedpeople, for example, by calling for the reduction of overcrowding and unnecessary incarceration. Despitethe retributive rhetoric that is popular among politicians and the public, the constitution mandates andrecognizes the right of people in prison to humane and dignified conditions of detention. These valuesare diffused through law and policy, supported by an independent judiciary, and monitored by a smallbut vigilant prisons-focused human rights community. These factors enable the courts to make decisionsthat facilitate systemic improvements in prison conditions—counter to popular sentiment favoringpunitive measures—and increase access to HIV and TB services in detention. This article examines aseries of strategic litigation cases that illustrate this process of change to remedy disease-inducing andrights-violating conditions in South African prisons.