TORONTO - The head of the Public Health Agency of Canada says a pilot program that provided sanitary tattooing to prisoners was cancelled before it could prove whether it was effective in preventing the spread of disease.
Dr. David Butler-Jones said "a relatively short space of time" like the single year given the pilot project is not long enough to conclusively show whether such a program would affect rates of HIV, hepatitis C and other infectious diseases among prisoners.
His comments were published online Wednesday in an article to appear in the Canadian Medical Association Journal.
But in an interview with The Canadian Press, Butler-Jones said he was not knocking Prime Minister Stephen Harper's government for chopping the $600,000 program last month - which Public Safety Minister Stockwell Day called not "demonstrably effective" and a waste of taxpayers' dollars.
"I'm not criticizing the government any more than when I was a medical officer (of health) . . . It's really not appropriate for me to criticize an individual or community or a government based on its decision."
"My job is to make sure they have the best advice possible."
Still, he said it would have been valuable from a public health perspective if the tattooing program had run longer to see if it actually affected infection rates among prisoners over time.
In a statement late Thursday, Day said the government refuses to "spend taxpayers' money on providing tattoos for convicted criminals.
"We believe that taxpayers' money should be put where it counts most. That means tackling crime and keeping drugs off our streets.
"We will continue to support effective programs that educate inmates on the health risks of using dirty needles."
A national survey suggests 45 per cent of prisoners get tattoos and 17 per cent have body piercing - often using dirty needles. The program trained an inmate to provide sterile tattoos to fellow prisoners under staff supervision.
"I think it would have been helpful, but at the same time governments who fund these things have every right to allocate the resource to those aspects (of broad disease-prevention strategies) as they see as most important," he said.
Butler-Jones, whose agency is charged with tracking and preventing illness while promoting good health practices, said he wasn't consulted before the Corrections Canada program was ditched. The pilot was launched in August 2005 with money from the $85-million federal AIDS Initiative, which is overseen by the Public Health Agency.
The prevalence of infectious diseases in Canadian prisons has long been of concern to public health officials, along with the cost of treating sick inmates.
Corrections Canada told the CMAJ that more than 3,300 male and female inmates in Canada's 54 prisons had hepatitis C in 2004, for a prevalence rate of 25 per cent, and almost 2,500 were released into the community that year. As well, almost 200 prisoners were infected with HIV.
The annual cost of treatment is $29,000 per inmate for HIV and $26,000 each for hepatitis C.
Day declined to release an evaluation of the pilot program conducted by Corrections Canada's audit branch, saying it's still being translated and is unavailable.
Dr. Francoise Bouchard, director general of health services for Corrections Canada, declined to comment on the public health consequences of killing the program, which was being tested at six prisons.
Demonstrating a reduction in disease transmission would require a long-term study, she told CMAJ. "The objective was to see if such a project could contribute to minimize the risk in terms of high-risk behaviours, and also to look at minimizing the risk of staff injuries, and to educate inmates about infectious disease, as well as promoting health and wellness, while maintaining security."
