Zambia is a high burden country for tuberculosis, tuberculosis /HIV and drug-resistant tuberculosis. Every year 59 000 people develop tuberculosis, out of which 19 000 (32%) are living with HIV and 1 900 have resistant tuberculosis.

It is estimated that there can be up to 100 times more tuberculosis in prison than among the general population. People in prison often come from a poor socio-economic background, and overcrowded and unventilated cells, coupled with undernutrition and poor access to- and quality of, health services, increase the risk of disease transmission and poor treatment outcomes.

In this project, called “Building bridges”, we bring together trained and empowered prison inmates (peers), and prison staff, to create systems for prevention and care of tuberculosis and HIV inside the correctional facilities. This includes tuberculosis screening for all new entries to prison, access to diagnosis and treatment, nutritional supplements and vegetable gardens, and infection control. The peers also regularly share information to their fellow inmates about tuberculosis and other health related topics in cell talks, at sporting events and through theatre.

The partner organization In But Free, meaning “inside prison, but free from infectious diseases” have worked to improve prison health since the 1990s, and are a key stakeholders and human right advocates towards the Zambian Correctional Service.