Ms Clayton was one of two resource persons when the Standing Committee on Human and Social Development and Special Programmes (HSDSP) of the SADC Parliamentary Forum met in Johannesburg, South Africa on Wednesday under the theme, “Towards developing a SADC Model Law on Prison oversight.”

Addressing the committee, whose members are from all over the SADC region, Ms Clayton decried the disproportionately high burden of disease in prisons compared to the general population.

“How we treat people in prisons is a reflection of the health and justice in our society,” she stated.

“Studies in Malawi, Zambia and Botswana show that TB prevalence in prisons is ten times higher than in the general population,” she said and advocated for mandatory TB screening upon admission and regular case finding as essential tools for disease control.

She decried the reliance on symptomatic TB diagnosis alone, saying it allows asymptomatic carriers to go undetected.

“This enables TB to spread unchecked in already overcrowded and poorly ventilated facilities,” Ms Clayton noted.

She argued that the grim prison conditions characterised by inadequate hygiene, poor nutrition, lack of ventilation, and disrupted power supply compound the problem.

“TB testing needs a stable electricity supply, and even food shortages affect treatment because TB medicine taken on an empty stomach can cause severe side effects,” she explained.

 “Good prison health is good public health. When prisoners return to society untreated, they do not just bring their personal baggage. They bring the burden of disease too,” she said.

Ms Clayton drew attention to the unique vulnerabilities faced by women, transgender people, and other key populations in prison.

“In 2023, HIV prevalence in closed settings was twice as high as in the general population. Transgender individuals, in particular, face both a higher risk of infection and a disturbing lack of access to treatment.”

She warned that women in prisons often suffer from sexual violence and exploitation.

“They may be forced into sex to obtain basic goods or services,” she said, adding that this, coupled with poor access to maternal care and antiretrovirals, threatens the health of both mothers and children.

She called for a “survivor-centred, multisectoral response to sexual violence in prisons,” with guaranteed access to medical care, psychosocial support, and reproductive health services.

“The intersecting inequalities based on gender, HIV status, and criminalised identities must be addressed if we are serious about justice and public health,” Ms Clayton contended.

She urged parliamentarians to see the proposed model law not as a bureaucratic exercise but as a transformative instrument. “Prison oversight is not a luxury. It is a necessity for health, for dignity, and for justice.”

Renowned Zambian health expert Dr. George Magwende spoke on the topic, “The Importance of Prison Oversight (to Protect Prisoners’ Right to Health).”

He traced the evolution of prison systems from ancient Mesopotamia and Egypt to modern correctional institutions and highlighted the persistence of systemic challenges which directly compromise inmates’ health and well-being.

He explained that oversight is not merely an administrative function but a critical pillar of justice that protects human rights, exposes unconstitutional practices, promotes transparency, and ultimately restores public trust in the criminal justice system.

He outlined numerous health-related challenges prevalent in prisons across the SADC region, including overcrowding, poor nutrition, inadequate sanitation, exposure to communicable diseases like TB, and limited access to essential medical services. According to Dr. Magwende, these conditions violate basic human rights and increase the burden on public health systems.

He warned that without consistent and empowered oversight, conditions in prisons are likely to deteriorate further, with overcrowding and neglect leading to full-blown humanitarian and health crises.

He identified major limitations undermining current oversight mechanisms. These include a lack of continuity among oversight teams, limited knowledge of international human rights frameworks, inadequate legal authority, and weak collaboration between parliaments and other stakeholders.

He also cautioned against political bias and indifference among oversight personnel, calling for a culture of empathy and non-partisan commitment to justice.

A particularly urgent issue raised was the plight of incarcerated women, especially those over the age of 45, who are often held in facilities designed for men and stripped of access to gender-sensitive services.

Dr. Magwende outlined a rights-based approach to prison health, advocating for access to preventive care, appropriate medical screening, psychological services, and parenting support for women behind bars.

He also supported the development of a comprehensive SADC Model Law on Prison Oversight, which would serve as a uniform tool to guide member states in aligning prison oversight practices with international human rights and public health standards.

The Model Law, once adopted, is expected to set regional standards for prison health, human rights protection, and post-release continuity of care.

Ends/.

-Moses Magadza is the Media and Communications Manager at the SADC Parliamentary Forum.