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The incarceration of transgender people is described as a “double punishment” based on lack of gender recognition and ability to gender affirm, and with their experiences and conditions in prison tantamount to torture. The purpose of this study is to illustrate the continued “double punishment” of incarcerated transgender people (in particular trans-women) and identify and describe breaches in human and gender rights and minimum standards of care.

There is limited global data on the numbers of incarcerated transgender people, an identified vulnerable prison group. There are inherent difficulties for prison authorities regarding placement, security aspects and management of transgender persons. While the concerns apply to all transgender prisoners, the current literature focusses mainly on transgender women and this commentary reflects this present bias. A socio-legal approach describes and evaluates international human rights’ conventions and human rights’ law, soft law instruments mandating non-discriminatory provisions in the prison setting and relevant European and domestic case law.

Transgender prisoners experience an amplification of trauma underpinned by lack of legal gender recognition, inability to gender-affirm, discrimination, transphobia, gender maltreatment and violence by other prisoners and prison staff. Despite obligations and recommendations in international human rights’ instruments and standard operating procedures at the prison level, very few countries are able to fully uphold the human rights of and meet the needs of transgender people in prison.

This study is important as it highlights the dearth of knowledge exploring human rights discourses and concerns related to the phenomenon of incarcerated transgender persons. It uniquely focusses on European and domestic law and illustrates the inherent tensions between human rights, sexual orientation and gender identity rights and security considerations regarding transgender issues in prisons. Rights assurances centre on the principles of equality, dignity, freedom of expression, dignified detention and the prohibition of inhumane treatment or punishment.

This paper explores the health rights of prisoners as defined in international law, and the mechanisms that have been used to ensure the rights of persons in detention to realise the highest attainable standard of health. It examines this right as articulated within United Nations and regional human rights treaties, non‐binding or so‐called soft law instruments from international organisations and the jurisprudence of international human rights bodies. It explores the use of economic, social and cultural rights mechanisms, and those within civil and political rights, as they engage the right to health of prisoners, and identifies the minimum legal obligations of governments in order to remain compliant with human rights norms as defined within the international case law. In addressing these issues, this article adopts a holistic approach to the definition of the highest attainable standard of health. This includes a consideration of adequate standards of general medical care, including preventative health and mental health services. It also examines the question of environmental health, and those poor conditions of detention that may exacerbate health decline, disease transmission, mental illness or death. The paper examines the approach to prison health of the United Nations human rights system and its various monitoring bodies, as well as the regional human rights systems in Europe, Africa and the Americas. Based upon this analysis, the paper draws conclusions on the current fulfilment of the right to health of prisoners on an international scale, and proposes expanded mechanisms under the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment to monitor and promote the health rights of prisoners at the international and domestic levels.

Supermaxes across the United States detain thousands in long-term solitary confinement, under conditions of extreme sensory deprivation. Almost every state built a supermax between the late 1980s and the late 1990s. This chapter examines the role of federal prisoners’ rights litigation in the 1960s and 1970s in shaping the prisons, especially supermaxes, built in the 1980s and 1990s in the United States. This chapter uses a systematic analysis of federal court case law, as well as archival research and oral history interviews with key informants, including lawyers, experts, and correctional administrators, to explore the relationship between federal court litigation and prison building and designing. This chapter argues that federal conditions of confinement litigation in the 1960s and 1970s (1) had a direct role in shaping the supermax institutions built in the subsequent decades and (2) contributed to the resistance of these institutions to constitutional challenges. The history of litigation around supermaxes is an important and as-yet-unexplored aspect of the development of Eighth Amendment jurisprudence in the United States over the last half century.

The purpose of the paper was to conduct a legal-realist assessment of the South African prison system response to COVID-19. Severely congested and ill-resourced prison systems in Africa face unprecedented challenges amplified by COVID-19. South Africa has recorded the highest COVID-19 positivity rate in Africa and, on March 15th 2020, declared a national state of disaster. The first prison system case was notified on April 6th 2020.

A legal-realist assessment of the South African prison system response to COVID-19 in the 12 months following initial case notification focused on the minimum State obligations to comply with human rights norms, and the extent to which human, health and occupational health rights of prisoners and staff were upheld during disaster measures.

A legal-realist account was developed, which revealed the indeterminate nature of application of South African COVID-19 government directives, ill-resourced COVID-19 mitigation measures, alarming occupational health and prison conditions and inadequate standards of health care in prisons when evaluated against the rule of law during State declaration of disaster.

This legal-realist assessment is original by virtue of its unique evaluation of the South African prison system approach to tackling COVID-19. It acknowledged State efforts, policymaking processes and outcomes and how these operated within the prison system itself. By moving beyond the deleterious impacts of the COVID-19 pandemic on the already precarious South African prison system, the authors argue for rights assurance for those who live and work in its prisons, improved infrastructure and greater substantive equality of all deprived of their liberty in South Africa.

The first case of COVID-19 in the Malawi prison system was reported in July 2020. Human rights organisations raised concerns about the possibility of significant COVID-19 outbreaks and deaths in the prison system, because of the poor infrastructure, lack of healthcare and adequate COVID-19 mitigation measures, existing co-morbidities (tuberculosis, HIV and hepatitis C), malnutrition and poor health of many prisoners.

The authors conducted a legal-realist assessment of the Malawian prison system response to COVID-19 during state disaster measures, with a specific focus on the right to health and standards of healthcare as mandated in international, African and domestic law.

The Malawi prison system was relatively successful in preventing serious COVID-19 outbreaks in its prisons, despite the lack of resources and the ad hoc reactive approach adopted. Whilst the Malawi national COVID plan was aligned to international and regional protocols, the combination of infrastructural deficits (clinical staff and medical provisions) and poor conditions of detention (congestion, lack of ventilation, hygiene and sanitation) were conducive to poor health and the spread of communicable disease. The state of disaster declared by the Malawi Government and visitation restrictions at prisons worsened prison conditions for those working and living there.

In sub-Saharan Africa, there is limited capacity of prisons to adequately respond to COVID-19. This is the first legal-realist assessment of the Malawian prison system approach to tackling COVID-19, and it contributes to a growing evidence of human rights-based investigations into COVID-19 responses in African prisons (Ethiopia, South Africa and Zimbabwe).

This paper makes the case for, and describes an effort to develop and promote the use of, model law to address HIV/AIDS in prisons. First, it outlines the concept of model law and what model law can bring to advocacy around law reform. Second, it describes why model law is particularly important to safeguard the rights of prisoners and people who use drugs. Third, it relates the methodology involved in developing model law. Three important areas of prison law and regulation related to HIV/AIDS are then described: provisions on the likelihood and duration of incarceration, including periods in pretrial detention; the legal foundation for HIV/AIDS care in prison; and the legal framework for comprehensive harm reduction services in prisons. A legislative framework to address rape and sexual violence in prison is also outlined. The paper sets out broad principles of how prison laws and regulations should be reformed to accord with human rights principles, and provides a number of examples of the specific wording of certain provisions.

Prisons in the sub-Saharan African region face unprecedented challenges during the COVID-19 pandemic. In Malawi, the first prison system case of COVID-19 was notified in July 2020. While prison settings were included in the second domestic COVID-19 response plan within the Law Enforcement cluster (National COVID-19 preparedness and response plan, July–December 2020), they were initially not included in the K157bn (US$210m) COVID-19 fund. The purpose of the study was to assess prison preparedness, prevention and control of COVID-19 in Malawi..

A multi-method situation assessment of the COVID-19 response and human rights assurance of prisoners and staff was conducted in a large prison complex in Malawi. Qualitative research underpinned by the Empirical Phenomenological Psychological (EPP) framework consisted of interviews with key informants such as prison health personnel, senior prison staff, penal and judicial policymakers, government and civil society organisations (n = 14) and focus group discussions with consenting male (n = 48) and female prisoners (n = 48) and prison wardens (n = 24). Prison site visits were supported by detailed observations based on the World Health Organisation Checklist for COVID-19 in prisons (n = 9). Data were collected and analysed thematically using the EPP stepwise approach and triangulated based on Bronfenbrenner’s model conceptualising COVID-19 as a multi-level event disrupting the prison eco-system.

The results are presented as MICRO-MESO level individual and community experiences of incarceration during COVID-19 spanning several themes: awareness raising and knowledge of COVID-19 in prisons; prison congestion and the impossibility of social distancing; lack of adequate ventilation, hygiene and sanitation and provisions and correct use of personal protective equipment; MESO-MACRO level interplay between the prison community of prisoners and staff and judicial policy impacts; medical system COVID-19 response, infrastructure and access to health care; COVID-19 detection and quarantine measures and prisoner access to the outside world.

This unique situation assessment of the Malawian prison system response to mitigate COVID-19 illustrates the dynamics at the micro-level whereby prisoners rely on the state and have restricted agency in protecting themselves from disease. This is due to severe structural inadequacies based on low resource allocation to prisons leading to a compromised ability to prevent and treat disease; an infirm and congested infrastructure and bottlenecks in the judicial system fuelling a continued influx of remand detainees leading to high overcapacity. Multi-pronged interventions involving key stakeholders, with prison management and line Ministry as coordinators are warranted to optimise COVID-19 interventions and future disease outbreaks in the Malawian prison system.

It is generally accepted that people in prison have a right to a standard of health care equivalent to that available outside of prisons. This “principle of equivalence” is one that enjoys broad consensus among international health and human rights instruments and organisations. However, given the extreme health problems evident in prisons worldwide, the legal obligations of the State to safeguard the lives and well‐being of people it holds in custody and the implications of poor prison health on overall public health, this article suggests that ‐ even if achieved ‐ standards of prison health care only equivalent to that in the community would in some cases fall short of human rights obligations and public health needs. The article argues it is time to move beyond the concept of equivalent standards of health care, and instead promote standards that achieve equivalent objectives. In some circumstances, meeting this new standard will require that the scope and accessibility of prison health services are higher than that outside of prisons.

The purpose of this paper is to explore whether, although the state has a duty to protect prisoners, there should nevertheless be a right for prisoners to decide when and how they die.

Utilising a utopian thought experiment, the paper covers a series of interrelated issues: the aims of punishment, the functions of prisons, the rights of prisoners and the responsibilities of the state towards inmates. While the paper takes a European focus, it is of interest to a global audience, as the philosophical ideas raised are universally applicable.

As the right to die advances in society, so should it advance for prisoners. Once assisted dying has been legalised, it should also be available for dying prisoners.

The question has so far not been analysed in depth. With an ageing prison population, however, it is vital that we start engaging with the problems posed by an ageing and dying prison population.

South Africa has been hailed as possessing one of the most progressive and visionary Constitutions in the world. It recognizes the right of everyone to have access to health care services. It also recognizes, in detail, various rights of accused, arrested and detained people, including the right to adequate medical treatment. However, despite the constitutionally entrenched rights, we (as civil society) are painfully aware that this does not magically transform the social conditions of the poor and marginalized amongst us. In fact, we have learnt that it is not only food, shelter and healthcare that cost money, but rights also. For without access to legal services in order to enforce one’s rights, they often remain not much more than paper ideals. This is recently demonstrated in the case of EN and Others v Government of the Republic of South Africa and Others , more commonly called the Westville Correctional Centre case (WCC case). This article will examine this case, and the implications of the right to adequate medical treatment for prisoners in South Africa, by addressing the factual background to the litigation, the legal and policy framework, the key issues that arose and the legal remedy.