Towards a health-informed approach to penal reform? Evidence from ten countries as 200 per cent. Hungary has seen some of Europe’s worst prison overcrowding in recent years and currently operates at 118 per cent of official capacity. In Australia, available data indicate that prisons are operating at 112 per cent of official capacity.21 Figure 6: Interior of cell at the Bács-Kiskun County Penitentiary Institution, Hungary (Photograph courtesy of Hungarian Helsinki Committee prison monitors) In summary, we can conclude that well over 60 per cent of countries worldwide have overcrowded prisons. The public health risks this presents are of great concern. Many of these countries have large prison populations, with potentially hundreds of thousands of individuals passing through their prisons each year. Many also have relatively low standards of community public health provision and carry heavier burdens of transmissible diseases including HIV/AIDS, hepatitis and tuberculosis. Prison overcrowding is usually a consequence of over-use of custody (including at the pre-trial stage), combined with insufficient investment in prison buildings and other resources. As we explain in the next chapter, reduced overcrowding is a precondition for better prisoner health. 21 Australia has not published a national official capacity figure since 2013: this was 31,335. We have sourced more recent state/territory capacity figures, to arrive at a current national capacity figure of 36,730, as reflected on the World Prison Brief database. 18