Medical neglect in U.S. prisons is an international disgrace. Whether contracted out to private providers or not, healthcare for incarcerated people is universally abysmal.

There are few places where this is more apparent than inside New Mexico’s state prisons, where it was recently reported that there is a virtual epidemic of untreated hepatitis C cases among the inmate population. An estimated 44 percent of state prisoners are infected with the virus, the highest known share of any prison system in the country. The infection rate among New Mexico’s overall population is an estimated 1 in 40 adults – 60 percent above the national average.

Hepatitis C—a liver disease—is primarily spread by blood-to-blood contact, often through sharing intravenous drug paraphernalia. High rates of infection are symptomatic not only of widespread addiction resulting from poverty, but a generalized lack of access to healthcare including harm reduction, basic screening and access to affordable antiviral medications.

Left untreated hepatitis C can lead to liver failure, liver cancer or death. According to a report from the Santa Fe New Mexican, “Out of some 3,000 prisoners diagnosed with the disease, just 46 received treatment for hepatitis C during the 2018 fiscal year.”

Inmates all over the country infected with hepatitis C face enormous barriers trying to access simple life-saving treatment. The first obstacle is that prisons are simply unwilling to pay for antiviral treatments. In the capitalist healthcare system, where human sickness is a for-profit business, the most effective antiviral therapies can cost upwards of $20,000 per treatment. New Mexico’s prisons will screen inmates for hepatis C, but they refuse treatment to most people after that.

Inmates in both state and federal prison are barred from using Medicaid or Medicare in prison.

Depriving prisoners of costly antiviral treatment to save money has become business-as-usual in America, and has incentivized prisons to fabricate all kinds of reasons to restrict prisoners from being “eligible” for treatment.

A June 2018 internal New Mexico Corrections Department memo, published online, stated that inmates with a history of disciplinary problems will not be considered for possible treatment. Even minor infractions such as “abusive language or gestures,” as determined by unscrupulous and cruel prison guards, is enough to exclude a prisoner from treatment for 12 months! Inmates who are not treated for hepatitis C immediately could have their livers scarred so badly that a liver transplant becomes necessary.

The pervasiveness of untreated hepatitis C in American prisons was recently brought into the national spotlight by one of the world’s most well-known political prisoners and former Black Panther, Mumia Abu-Jamal. After contracting the deadly liver infection, Mumia faced what he called “slow death row,”—that is, “death by medical neglect.” After more than two years of legal battles against the Pennsylvania Department of Corrections, Mumia won the right to be treated in 2017. The federal court decision was also a victory for the 7,000 Pennsylvania state prison inmates who are also now receiving treatment.

There are now several other lawsuits that are sure to have an impact, both in New Mexico and across the nation. Courts in Florida, Massachusetts, Colorado and Louisiana have all ruled that prisons in these states are required to provide treatment for inmates diagnosed with hepatitis C.

In some cases, such as Louisiana, several of the inmates who filed the initial claim died before the trial even began.

In each of these states, courts ruled that deprivation of treatment amounted to cruel and unusual punishment under the Eighth Amendment. These victories have led directly to other states with longstanding crisis or their own, like New York and Washington, to preempt litigation by announcing initiatives to widen access to treatment in prisons.

This trend of reforms will help save the lives of many prisoners who languish in U.S. prisons from “death by medical neglect,” at least when it comes to hepatitis C. What will remain unaddressed is the prison healthcare crisis in general, as well as another major public health crisis, one intimately linked to the spread of hepatitis C: opioid addiction.

Lack of opportunity and despair caused by capitalist unemployment and underemployment, especially among those cast aside after fighting in never-ending imperialist wars, has created the conditions for widespread addiction to flourish. The pharmaceutical industry has literally capitalized off of this, creating a criminal racket worth hundreds of billions of dollars aggressively marketing and selling drugs with a high potential for abuse and dependency.

There is a growing consensus among the working class that healthcare is a fundamental right. Concepts such as single-payer healthcare are more and more popular. It is critical that demands for universal healthcare extend to the millions of working class people trapped in the prison-camps-for-the-unemployed known as the U.S. prison system.