At its annual General Assembly in Tel Aviv, Israel, the WMA agreed to develop guidelines for physicians because it believed that adverse prison conditions across the world were leading to the spread of infection and risking the health of prisoners, prison visitors, prison staff and medical staff.

The meeting heard of the crisis over the spread of tuberculosis among prisoners in the former Soviet Union, but also of problems elsewhere, including the development of hepatitis C in prisons in Australia and the continuing threat from HIV infection.

Dr James Appleyard, chairman of the WMA's working group on human rights, said:

'These problems are the direct result of an abuse of human rights. They cannot be dealt with in conditions where there are overcrowded cells, no sunlight, no proper diet and inadequate medical care. It is a crisis because these infections, including drug resistant organisms, are spreading outside the prisons'.

'What we desperately want to see is a change in prison conditions and our guidelines will include issues such as the need for medical screening in prison, availability of effective treatment, confidentiality and the crucial independence of physicians'.

Dr Appleyard said that the WMA would also be examining the health care plight of detainees.

'In many parts of the world, detainees are being denied the right to the same quality of health care as the rest of the population. Physicians looking after them also have the right to expect that they will have the same freedoms to offer care in the right way to their patients'.