Israel Prison Service Refrains From Treating Prisoners With Hepatitis C Due to High Costs

Contagion rates in prisons are high due to fights, needle sharing and sexual intercourse.

Inmates at Rimonim Prison in central Israel (illustrative).
Moti Milrod

New treatment for Hepatitis C is included in the state-funded health basket, but the Prison Services refrains from treating this serious viral infection among inmates. The Service also avoids taking preventive measures such as diagnostic tests and providing prisoners with information. The reason for this, according to the Service, is the high costs involved.

The Prison Service is obliged to provide prisoners with the same services provided by health maintenance organizations to the general public, including the diagnosis and treatment of diseases such as Hepatitis C. Last May, the central District Court ruled in favor of a petition by a prisoner with Hep C. The court instructed the Prison Service to provide him with medication included in the health basket. Prison service medical personnel had argued that the costs would exceed their budget but the judge ruled that this could not justify withholding treatment.

Prisoners are considered among the groups at highest risk of being infected. The Hep C virus is transmitted through bodily fluids, particularly blood. In Israel, people receiving transfusions before 1992, drug addicts using needles and former citizens of the Soviet Union are considered to be at high risk.

The disease can go unnoticed for years but usually leads to chronic liver inflammation and eventually failure.

“Studies show that 25 percent to 30 percent of prisoners are infected,” says Julio Borman, the head of Hetz, a liver health advocacy group. “A prisoner told me how four people in a cell share a razor, with one inmate carrying the virus.” Infection rates are high, Borman says, due to needle sharing while consuming drugs, sexual intercourse, tattooing and fighting.

The Prison Service, the Health Ministry and the Public Security Ministry acknowledge the problem. Commissioner of Prisons Ofra Klinger appealed to the health minister, claiming that insufficient funds are an urgent humanitarian issue. In response, the minister ordered the drug to be sold to prisons at reduced rates. “Drug companies offered rock-bottom prices and the funding of a doctor to check prisoners, but nothing has moved,” says Borman.

Following an appeal by MK Tamar Zandberg (Meretz), who heads the Knesset committee on drug abuse, Public Security Minister Gilad Erdan said that Hep C patients would be treated out of Prison Service budgets. Five months later no treatment has yet been initiated.

The Prison Service stated in response that it “deals with sick prisoners according to Health Ministry guidelines. Since the ministry has not issued a directive to any medical organization or the Prison Service to track Hep C patients, this has not been done.”

The Health Ministry commented that “the responsibility for medically insuring prisoners is the Prison Service’s responsibility, and it should provide medications that are in the health basket.”