Correctional institutions The commission emphasised that the approach used by those responsible in Graz-Karlau correctional institution is commendable. First of all, the antibody status of the inmates is documented. If the result if positive, the genotype and viral load are determined, and the inmate is transported to the specialised department in Graz Regional Hospital. The internist issues a clear treatment recommendation after which those responsible at Graz-Karlau correctional institution immediately submit applications for treatment to the Federal Ministry of Justice in order to be allocated the medication necessary for the recommended treatment. Fast assessment It can sometimes take up to a year until decisions are made. There are considerable delays not just in isolated cases. The procedure is completely untransparent. Those affected do not receive a reply for a very long time. On the day of the visit, it was not evident to the delegation which criteria are used for approval, how long an approval lasts and why persons have to wait so long for decisions. Long decision processes Therapy requests are not rejected either. The remark “not confirmed” is merely entered in the “Approval” section in the electronic medical record. The consequence is that some inmates are still waiting for approval years later. Years of uncertainty The NPM requested disclosure of the criteria used for granting approvals and why there are such long waiting times. Reference was made to the jurisdiction of the European Court of Human Rights according to which states have an obligation to take effective measures against infectious diseases in prisons and to assess the state of health of detainees by examination in order to promptly grant them access to necessary treatment, failing which there is a breach of Article 3 of the ECHR (European Court of Human Rights 18 December 2012, Jeladze v Georgia, Appl. No. 1871/08, recital 42; European Court of Human Rights 12 July 2007, Testa v Croatia, Appl. No. 20877/04, recital 51). The general directorate stated that the quality of care for patients with HCV therapy in Graz-Karlau correctional institution has improved due to the hiring of a specialist in internal medicine (specialised in gastroenterology) and can therefore be provided on-site regularly. In this way, both the patients who receive a therapy and those who have completed a therapy (with follow-up care needs) are well looked after. Besides, as stated by the general directorate, an elimination plan has been drawn up with the Federal Ministry of Social Affairs, Health, Care and Consumer Protection according to which 45 to 50 therapy places are offered per year depending on the financial situation. Considering the current number of ill patients, this is also in line with the goals of the WHO. These therapy places are distributed to all 28 correctional institutions in Austria. Graz-Karlau correctional institution has, with its inmate population, a larger share than other correctional institutions. Furthermore, the allocation of three Medication subject to a quota 118