The absence of prison needle and syringe programs in Australian prisons constitutes a breach of human rights and international law, requiring leadership and respect for evidence to correct, according to the authors of a Perspective published in the Medical Journal of Australia.

A group of experts led by Associate Professor Mark Stoové, head of the HIV and Justice Health Research programs at the Burnet Institute in Melbourne, said even though prison needle and syringe programs (PNSPs) are endorsed by Australian health and medical peak bodies, including the Australian Medical Association, Australasian Society for HIV Medicine and the Royal Australasian College of Physicians, as well as global bodies like the World Health Organization, UNAIDS and the United Nations Office on Drugs and Crime, only eight countries currently maintain PNSPs, leaving 74 countries, including Australia, that support community needle and syringe programs but not PNSPs.

Only the Australian Capital Territory has shown leadership on this issue, with successive chief ministers, Jon Stanhope and Katy Gallagher, supporting trialling a PNSP at the Alexander Maconochie Centre (AMC). Stoové et al said that evidence shows that people who inject drugs (PWID) are grossly overrepresented in Australian prisons, and up to 58% of prisoners nationally report lifetime injecting histories. The prevalence of blood-borne viruses (BBVs) - commonly transmitted through sharing injecting equipment - is also substantial in prison, with high rates of intra-prison hepatitis C (HCV) transmission reported.

"Unlike in the community, PWID in Australian prisons cannot access sterile needles and syringes", the authors wrote.

"Research and evaluation evidence shows no increase in drug use or availability following PNSP implementation and no reports of needles and syringes provided by PNSPs being used as weapons, or safety problems associated with syringe disposal."

"While it is hoped that AMC staff might depart from the CPSU's historical resistance to PNSPs, the ACT Government must show the leadership lacking in other jurisdictions by allowing evidence and expert advice, rather than unions, guide public health policy."