CEDH · CASELAW;JUDGMENTS;CHAMBER;ENG — 7 avril 2026

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SERBIA (Application no. 19083/20)       JUDGMENT   Art 3 (substantive and procedural) • Positive obligations • Court unable to conclude based on the available material that the applicant contracted tuberculosis in prison, or that a concrete and proven risk of such infection was created by an omission attributable to the respondent State • Despite shortcomings in the preventive arrangements, there was no delay or deficiency in the medical response once the illness was suspected • Adequate and effective medical treatment • No situation of endemic or uncontrolled tuberculosis transmission at the relevant time • Adequate material conditions • Requisite threshold not attained • Shortcomings in civil proceedings did not prevent domestic courts from addressing substance of the applicant’s allegations and insufficient to disclose a violation of Art 3   Prepared by the Registry. Does not bind the Court.   STRASBOURG 7 April 2026   This judgment will become final in the circumstances set out in Article 44 § 2 of the Convention. It may be subject to editorial revision. In the case of Cekić v. Serbia, The European Court of Human Rights (Third Section), sitting as a Chamber composed of:   Ioannis Ktistakis , President ,   Lətif Hüseynov,   Darian Pavli,   Diana Kovatcheva,   Úna Ní Raifeartaigh,   Mateja Đurović,   Canòlic Mingorance Cairat , judges , and Milan Blaško, Section Registrar, Having regard to: the application (no. 19083/20) against the Republic of Serbia lodged with the Court under Article 34 of the Convention for the Protection of Human Rights and Fundamental Freedoms (“the Convention”) by a Serbian national, Mr   Miloš Cekić (“the applicant”), on 7 April 2020; the decision to give notice to the Serbian Government (“the Government”) of the complaints concerning the alleged ill-treatment of the applicant and to declare inadmissible the remainder of the application; the parties’ observations; Having deliberated in private on 17 March 2026, Delivers the following judgment, which was adopted on that date: INTRODUCTION 1.     The case concerns the conditions of the applicant’s detention at Sremska Mitrovica Correctional Institution. It further relates to the applicant’s alleged contraction of tuberculosis during his imprisonment and the adequacy of the medical treatment provided for that illness. THE FACTS 2.     The applicant was born in 1973 and is currently serving a prison sentence in Požarevac-Zabela Correctional Institution. He was represented by Ms S. Kovačević, a lawyer practising in Belgrade. 3.     The Government were represented by their Agent, Ms Z. Jadrijević Mladar. 4.     The facts of the case may be summarised as follows. 5 .     On 14 May 2008 the applicant started serving a prison sentence at Sremska Mitrovica Correctional Institution (hereinafter “Sremska Mitrovica Prison”) after being convicted on three counts of robbery. Prior to that, he had been detained in Novi Sad District Prison for approximately 11 months. The applicant submitted that he had spent several years in various correctional facilities before that period, although there is no evidence for that in the case file. On 2 December 2011 the applicant was transferred to Požarevac-Zabela Correctional Institution.         THE CONDITIONS OF THE APPLICANT’S DETENTION DURING SOLITARY CONFINEMENT AND ENHANCED SUPERVISION 6 .     The applicant submitted that he had spent 180 days under enhanced supervision during the months of February, March and July 2009, during which periods he had been held in a cell with three other prisoners, and that he had been held in solitary confinement for 15 days. Enhanced supervision is a special measure for the preservation of order and security in prison and solitary confinement is a disciplinary measure (see paragraphs 37 and   38 below). The applicant submitted that his cell during the periods of enhanced supervision had measured 15 sq. m and had been dirty and damp. The room used for solitary confinement had also been dirty and damp. He stated that he had been placed in the “enhanced supervision department” located in the fourth wing of the prison. He added that, although that department has since been relocated to the third wing, prisoners continued to be detained in that particular room for various reasons. 7 .     The Government submitted that the applicant had been subjected to the disciplinary measure of solitary confinement between 13 and 28 March 2009 and between 23 September and 8 October 2009. Prison doctors had certified that he had been in a suitable state of health to undergo that measure. He had been placed under the special measure of enhanced supervision between 18   February and 8 April 2009 (save for the period of solitary confinement) and again between 25 June and 23 September 2009. On all of these occasions, he had been held in the disciplinary department ( disciplinski deo – odeljenje ), which had been renovated in 2006. While in solitary confinement he had been accommodated in a room measuring 13.5 sq. m with a total volume of 29.7   cubic metres; while under enhanced supervision he had shared with one person a room measuring 16.5 sq. m with a total volume of 36.3 cubic metres. The rooms had been clean and orderly, benefited from natural light and ventilation, and each had been equipped with a toilet, a sink, beds, chairs, a table and a locker for clothes storage. During both solitary confinement and enhanced supervision the applicant had showered in a communal bathroom, had had two hours per day of out ‑ of ‑ cell time in the open air, and had been allowed to make telephone calls and to go to the prison canteen. That information had been provided in a report by the Directorate for the Execution of Criminal Sanctions ( Uprava za izvršenje krivičnih sankcija ) dated 1   April   2024.       THE APPLICANT’S MEDICAL CONDITION 8 .     On 15 May 2008, following his admission to Sremska Mitrovica Prison (see paragraph 5 above), the applicant underwent a medical examination. On that occasion he informed the doctors that he had hepatitis C and that he had used various drugs. He did not report to the prison doctor any symptoms commonly associated with tuberculosis, nor did he indicate that anyone close to him suffered from that disease. The applicant had regular meetings with a psychiatrist who prescribed him therapy for his drug-related problems. 9 .     Between 15 May 2008 and 17 October 2010 the applicant was examined 65 times by doctors working at Sremska Mitrovica Prison and a specialist in neuropsychiatry. There is no record that the applicant complained of any breathing problems at those examinations. 10 .     On 18 October 2010 the applicant saw a doctor at Sremska Mitrovica Prison in relation to a sore throat, runny nose and coughing. He was prescribed antibiotic therapy (Palitrex (Cefalexin)) and was advised to return for a follow-up examination if the symptoms worsened. 11 .     On 5 November 2010 the applicant underwent routine chest photofluorography, which revealed a visible change in the lung area raising a suspicion of tuberculosis infection. The applicant was isolated from other convicted persons to prevent spread of a possible infection. 12 .     On 9 November 2010 the applicant was admitted to the Special Prison Hospital ( Specijalna zatvorska bolnica – hereinafter “the Prison Hospital”) in Belgrade for further monitoring. According to the admission report, the applicant was not coughing and had no respiratory difficulties or any other symptoms of discomfort. On 13 December 2010 he was diagnosed with tuberculosis following bronchoscopy and microbiological testing. 13 .     The applicant was given antibiotic treatment against tuberculosis at the Prison Hospital from 15 December 2010 until 1 April 2011, when he was discharged from hospital and returned to Sremska Mitrovica Prison. Before being transferred, the applicant’s sputum had tested negative for tuberculosis. His antibiotic treatment continued until 14 June 2011. The applicant tested negative for Mycobacterium tuberculosis bacteria on 11 July and 3   August 2011. He was left with residual scarring which does not impair his respiratory function. His health status has been subject to annual monitoring and the scarring is healing.     COURT PROCEEDINGS AT THE DOMESTIC LEVEL    Proceedings for preservation of evidence 14.     On 21 April 2011, prior to lodging a compensation claim (see paragraph   17 below), the applicant submitted an application to the Sremska Mitrovica Court of First Instance aimed at securing evidence regarding the conditions of his detention during the periods he spent in solitary confinement and enhanced supervision in 2009 (see paragraph 6 above). He requested that the domestic court order an on-site inspection and obtain an expert opinion from a construction specialist. 15 .     On 3 September 2012 the Sremska Mitrovica Court of First Instance dismissed his application. Referring to Article 269 of the Civil Procedure Act then in force (see paragraph 40 below), the court found no well-founded concern that the evidence in question might become unavailable or that its subsequent production would be significantly hindered. It held that the conditions of detention could be established through the testimony of other prisoners. As for the request to appoint a construction expert, the court considered that such an expert would not be competent to assess the conditions of detention. 16 .     The applicant lodged an appeal against that decision. On 25   December 2012 the Sremska Mitrovica Court of Second Instance dismissed that appeal and upheld the decision of the first-instance court. With regard to the applicant’s assertion that the authorities might renovate the room in which he had been detained, the court considered that to be a speculative argument.    Civil proceedings 17 .     On 25 November 2011 the applicant brought a compensation claim against the Republic of Serbia. The applicant sought 4,000,000 Serbian dinars (RSD – approximately 39,000 euros (EUR)) in respect of non-pecuniary damage flowing from the fear suffered and a reduction in his ability to engage in daily activities related to his contracting of tuberculosis while detained in Sremska Mitrovica Prison. Specifically, he contended that he had been infected when he was held under enhanced supervision and solitary confinement, in conditions amounting to inhuman and degrading treatment, and that he had not been provided with adequate medical assistance. He described the cells in the manner summarised in paragraph 6 above. His complaints related to two periods of enhanced supervision, lasting 180   days in total, and to 15 days of solitary confinement. 18 .     On 1 November 2013 the applicant was heard before the Belgrade Court of First Instance no. 1 (hereinafter “the Belgrade Court of First Instance”). During that hearing the applicant submitted that he was seeking compensation for damage to his health. He alleged that he had been subjected to solitary confinement and enhanced supervision in Sremska Mitrovica Prison under conditions incompatible with human dignity. In particular, he claimed that the cells had been cold and damp, that while under enhanced supervision he had shared the cell with two other persons, and that use of that cell had subsequently been discontinued owing to its condition. He maintained that, as a result, he had experienced extreme physical weakness. Following consultations with prison medical staff he had been transferred to the Prison Hospital, where he had undergone treatment for tuberculosis. While he stated that his health had improved after the treatment, he contended that he had been suffering acute psychological distress upon admission to the Prison Hospital because he had been unaware of the nature of his illness. He further stated that the tuberculosis had left scarring on his lungs and that he was required to undergo annual medical check-ups. 19 .     On 25 October 2016, a commission of three experts (a specialist in pulmonology and phthisiology, a permanent court expert specialised in neuropsychiatry, and a permanent court expert specialised in forensic medicine) delivered an opinion to the first-instance court. 20 .     The report indicated that the applicant’s tuberculosis had been detected during routine chest photofluorography at Sremska Mitrovica Prison. It stated that the applicant had not experienced pulmonary discomfort before or during the successful treatment, which suggested that he had not suffered physical pain. As for the residual scarring on his lungs, the report indicated that it neither impaired his breathing capacity nor limited his ability to engage in daily activities. On the basis of a report submitted by Sremska Mitrovica Prison, in which it was indicated that no other prisoners had been diagnosed or treated for tuberculosis in 2009, the commission concluded that prison transmission had been impossible (the report prepared by Sremska Mitrovica Prison is not part of the case file). It noted that a prior infection could have reactivated owing to weakened immunity during solitary confinement, as imprisonment was inherently stressful. It was further noted that the applicant likely experienced some fear between learning of his diagnosis and receiving his first conclusively negative test result. 21 .     On 5 January 2017 the applicant requested the expert commission to clarify whether there existed a causal link between the conditions of his detention during solitary confinement and the activation of tuberculosis. On 6   March 2017 he applied to the first-instance court for a new expert opinion, alleging that the commission had failed to address whether he had contracted tuberculosis while in prison. That application was rejected. On 28 April 2017 the expert commission replied: “As there were no registered cases of active tuberculosis among the applicant’s fellow prisoners, the commission unequivocally concluded that the applicant could not have become infected during his stay in the prison community. ... It is evident that prolonged exposure to poor living conditions (cold, dampness, lack of hygiene etc.) certainly creates circumstances conducive to the activation of diseases such as tuberculosis and the further aggravation thereof. However, our opinion also noted that the injured party did not suffer from a severe form of tuberculosis; rather, the disease was detected during routine systematic chest photofluorography, and throughout the entire course of treatment he did not experience even a minor impairment of respiratory function.” 22 .     In a submission of 26 May 2017 the applicant amended his compensation claim. While maintaining the amount previously requested, he clarified that he sought compensation for non-pecuniary damage arising from physical pain and from the alleged violations of his rights to life and health, in addition to the grounds already raised in his claim of 25 November 2011 (see paragraph 17 above). He further stated that the measures of solitary confinement and enhanced supervision to which he had been subjected had been implemented in conditions of detention that violated human dignity. 23 .     In the same submission the applicant raised additional objections concerning the expert opinion. He noted that the case file did not indicate whether other prisoners in Sremska Mitrovica Prison had had tuberculosis. He also argued that, prior to his transfer to Sremska Mitrovica, he had spent time in Novi Sad District Prison and could have contracted tuberculosis there. He requested the first-instance court to obtain precise information from the prison authorities regarding the exact periods of his detention there before the transfer. Finally, the applicant contended that the expert opinion had failed to address whether the conditions of his detention had contributed to the development of tuberculosis. 24 .     On 5 June 2017, the Belgrade Court of First Instance granted the applicant leave to amend his claim (see paragraph 22 above) and dismissed it as unfounded. The judgment records that, in his reply to the defendant’s observations, the applicant had stated that he was seeking compensation for non ‑ pecuniary damage solely on account of the lasting effects on his health, and not for any alleged violation of human dignity or personal rights, nor for any alleged breach of the right to a trial within a reasonable time. 25 .     The applicant’s claim was dismissed primarily with reference to the expert opinion (see paragraphs 19-21 above). The applicant had requested the first-instance court to summon another prisoner as a witness, but the request had not been granted as he had failed to provide the witness’s address. His further requests for a new expert opinion and for information concerning his incarceration prior to his transfer to Sremska Mitrovica Prison had likewise been rejected. 26.     Relying on Article   200 §   1 of the Obligations Act (see paragraph   41 below), the first-instance court found that it had not been established that the applicant had sustained the damage for which he sought compensation. It considered that the applicant had failed to demonstrate that the illness had had any lasting effects diminishing his ability to carry out daily activities. The first-instance court further held that the intensity and duration of the fear experienced by the applicant did not justify an award of monetary compensation, particularly in view of the successful outcome of treatment following the diagnosis and prescribed therapy. The same conclusion was reached regarding the physical pain allegedly caused by medical treatment itself (namely the administering of injections), with the court noting that the applicant had not proved that the illness itself had caused him any discomfort. Lastly, the court held that the applicant could not claim compensation for an alleged violation of his rights to life and health, given the absence of physical pain, fear, or any reduction in his ability to carry out daily activities warranting compensation. 27 .     As regards the applicant’s allegation that the conditions of detention in solitary confinement and enhanced supervision had contributed to the onset of tuberculosis, the first-instance court held that it was unnecessary to rule on that issue. It relied on the expert opinion stating that no other prisoners at Sremska Mitrovica Prison had been diagnosed or treated for tuberculosis in 2009 (see paragraph 20 above). The court further emphasised that the applicant had not claimed compensation for detention in inhuman conditions and therefore there was no need to establish whether those conditions had existed (see paragraph 24 above). 28 .     The applicant lodged an appeal in which he challenged the first-instance court’s finding that he could not have contracted tuberculosis in prison. He argued that that conclusion, which was based on the report indicating that no other prisoners at Sremska Mitrovica Prison had been diagnosed or treated for tuberculosis in 2009, was unreliable given that preventive screenings in that institution were only carried out occasionally. Furthermore, he submitted that the court had failed to address the fact that he had been detained within the Serbian prison system prior to 2009. He also complained that the first-instance court had not examined his allegation that the conditions of his detention in solitary confinement and enhanced supervision had contributed to the activation of tuberculosis. Lastly, the applicant contested the dismissal of his claim concerning an alleged violation of his rights to life and health, maintaining that the damage to those rights had resulted from his detention in inhuman conditions, which in turn had led to his tuberculosis. 29 .     On 7 December 2017, the Belgrade Court of Appeal dismissed the applicant’s appeal as unfounded and upheld the first-instance judgment, finding that the applicant had not sustained non-pecuniary damage warranting compensation under Article 200 of the Obligations Act. As regards his allegation that detention in allegedly inhuman conditions had caused tuberculosis, the second-instance court held that it had been established that the applicant could not have contracted the disease in prison. It further observed that the medical examination of 15 May 2008 that had been carried out on his arrival at Sremska Mitrovica Prison had shown that he had not been suffering from tuberculosis at that time (see paragraph 8 above). The court concluded that the first-instance judgment had correctly dismissed the claim for compensation for alleged breaches of the rights to life and health, as the tuberculosis infection had not been a direct consequence of his detention and had not caused non-pecuniary damage as defined by Article 200 of the Obligations Act.    Proceedings before the Constitutional Court 30 .     Following the appeal-court ruling, the applicant lodged a constitutional appeal in which he challenged the judgments of 5 June and 7   December 2017. He relied on Article 24 § 1, Article 25, Article 32 §   1, Article   36 § 1 and Article 68 § 1 of the Constitution (see paragraph 32 below). In outlining the alleged violations of Article 24 § 1, Article 25 and Article   68 §   1 of the Constitution (respectively the right to life, inviolability of physical and mental integrity and right to health), the applicant challenged the dismissal of his compensation claim and contended that those rights had been breached “by the conduct of the respondent towards [him], having regard to the previously described manner of enforcing the disciplinary measure of strict isolation”. The applicant submitted that he had contracted tuberculosis while detained in Sremska Mitrovica Prison and that he had not been provided with adequate medical care. He complained of spending 180 days under enhanced supervision and 15 days in solitary confinement in conditions which he described as inhuman and degrading, in terms similar to those used before the Court (see paragraph 6 above). He reiterated his complaint that the authorities had failed to investigate the possible link between those conditions and his tuberculosis infection. He further argued that the lower courts had relied on a prison report stating that no prisoners had been infected or treated for tuberculosis in 2009, without addressing the fact that he had also been detained in prisons throughout 2007 and 2008 (see paragraphs 5 and   28 above). The applicant also complained about the decision to reject his application seeking the preservation of evidence (see paragraphs 15 and   16 above) and about the decision not to order a new expert opinion (see paragraph   25 above). 31 .     On 11 July 2019, the Constitutional Court rejected the applicant’s constitutional appeal. His allegation that the trial had been unfair (Article   32 §   1 of the Constitution) was rejected as a “fourth-instance” complaint. His complaint under Article36 §1 was rejected as manifestly ill-founded. Finally, the complaints under Article 24 § 1, Article 25 and Article 68 § 1 of the Constitution were dismissed on the ground that they did not relate to the substance of the contested judgments. RELEVANT LEGAL FRAMEWORK AND PRACTICE         DOMESTIC LEGAL FRAMEWORK, PRACTICE AND DOCUMENTS    The Constitution of the Republic of Serbia ( Ustav Republike Srbije , published in the Official Gazette of the Republic of Serbia – OG RS – no.   98/06) 32 .     Article 24 § 1 provides that human life is inviolable. Article   25 provides that physical and psychological integrity are inviolable and that no one can be subjected to torture, inhuman or degrading treatment or punishment, or to medical and scientific experimentation without their freely given consent. Article 32 § 1 provides, inter alia , that everyone shall have the right to a fair hearing before a tribunal in the determination of his or her rights and obligations. Article 36 § 1 guarantees equal protection of rights before courts and other state authorities, holders of public powers, and the authorities of autonomous provinces and local self-government units. Article 68 §   1 provides that everyone has the right to the protection of their physical and mental health.    Execution of Criminal Sanctions Act ( Zakon o izvršenju krivičnih sankcija , published in the OG RS nos. 85/05, 72/09, and 31/11, currently not in force) 33.     Article 60 § 1 provided, inter alia , that, following incarceration, the authorities had to identify a convicted person, carry out a medical examination of him or her and open a medical file. 34.     Article 65 provided that everyone had to respect the dignity of the convicted person and that no one should endanger the physical or mental health of the convicted person. Article 67 provided, inter alia , that the premises in which convicted persons lived and worked had to be clean, dry, ventilated, heated, and adequately lit both by natural and by artificial light that enabled reading and work without impairing eyesight. Dormitories had to be sufficiently spacious so that each convicted person had at least 8   metres cubed and 4 sq. m of space. 35.     Article 101 provided, inter alia , that convicted persons had the right to healthcare in accordance with the general regulations on health protection and the provisions of the Law. Where adequate health care could not be provided within the institution, the person had to be transferred to the Special Prison Hospital or another health care facility. 36.     Article 103 set out the duties of doctors in prison institutions. Relevant to the present case was their obligation to examine each convicted person immediately upon arrival, assess his or her physical and mental health and capacity for work upon incarceration and, when necessary, promptly attend to any person who complained of illness or showed signs of being ill, conduct daily examinations of those who were ill, and perform regular check-ups of all other convicted persons at intervals not exceeding three months. 37 .     Pursuant to Article 136 §§ 1 and 2 the measure of enhanced supervision ( smeštaj pod pojačan nadzor ), one of the special measures ( posebne mere ) set out in that provision, could exceptionally be ordered in respect of a convicted person who posed a risk of escape, violent behaviour, self-harm, or any other threat to order and security that could not be eliminated by other means. 38 .     Placement in solitary confinement during leisure time or throughout the entire day and night ( upućivanje u samicu u slobodno vreme ili tokom celog dana i noći ) was a disciplinary measure ( disciplinska mera ). It could be imposed only exceptionally, for serious disciplinary offences, and could not exceed 15 days, or 30 days in case of concurrence of disciplinary offences (Article   150). Solitary confinement entailed the exclusion of the convicted person from joint activities with other convicted persons during leisure time or throughout the entire day and night (Article 151 § 1). Article 152 §   1 provided that the room in which solitary confinement was enforced had to measure at least 4 sq. m and have 10 cubic metres of space. It had to be ventilated, lit by both natural and artificial light, be heated in accordance with climatic conditions, and equipped with a bed and bedding, a table, and a chair. In accordance with Article 153 § 1 a convicted person in solitary confinement had to undergo a medical examination at least once a day. The length of time a convicted person spent in solitary confinement could not exceed six months within a single calendar year. The governor of the institution had to immediately discontinue the enforcement of the measure if, according to a written medical opinion, further confinement would endanger the convicted person’s health (Article 154 and Article 155 § 2).    Civil Procedure Act 2004 ( Zakon o parničnom postupku , published in the OG RS nos. 125/04 and 111/09) 39.     Article 193 § 1 of the Civil Procedure Act 2004, which was in force at the relevant time, provided that the claimant could amend the claim until the conclusion of the main hearing. 40 .     Article 269 of the Act provided that it was possible, if there was a well-founded concern that certain evidence would become unavailable or that its subsequent production would be significantly hindered, to request the taking of such evidence either during the civil proceedings or prior to their initiation.    Obligations Act ( Zakon o obligacionim odnosima , published in the Official Gazette of the Socialist Federal Republic of Yugoslavia nos.   29/78, 39/85, 45/89, and 57/89, the Official Gazette of the Federal Republic of Yugoslavia no. 31/93, and OG RS no. 18/20) 41 .     Article 200 provides, inter alia , that where the circumstances of the case justify it, particularly having regard to the intensity and duration of the pain and fear, a court will award just satisfaction in the form of monetary compensation for non-pecuniary damage arising from physical pain, mental suffering due to diminished quality of life, harm to liberty or personal rights, and fear.     The National Ombudsperson ( Zaštitnik građana ), the National Mechanism for the Prevention of Torture ( Nacionalni mehanizam za prevenciju torture – “the NPM”), Report on the Visit to Sremska Mitrovica Prison, carried out from 9 to 11 April 2012, 71-161/12 42 .     In the introductory part, it was stated that the prison had separate quarters for the accommodation of prisoners subject to enhanced supervision and solitary confinement. 43 .     It was reported that the third wing accommodated prisoners subjected to enhanced supervision and those in solitary confinement. Although the building was old, the wings of the “T” shaped building had been reconstructed and were in good shape (see p. 30 of that report). Prisoners subject to enhanced supervision were held in a separate part of that building. The NPM team visited one cell, measuring approximately 10 sq. m, which accommodated two prisoners. The material conditions were reported to be adequate and there was no sign of moisture on the walls. The NPM team talked to one prisoner held under enhanced supervision and he had no complaints (see pp. 91-92 of that report). 44 .     As for solitary confinement, the prisoners subjected to that sanction were also held in a separate part of the building of the third wing. The NPM team visited one cell measuring 8 sq. m. The material conditions were adequate and there was no sign of moisture. The team spoke to one prisoner who was in solitary confinement and he had no complaints (see pp. 93-95 of that report). 45 .     The report noted that the first medical examination of a person deprived of liberty upon arrival was carried out by a general practitioner, no later than within 24 hours from the moment of arrival. The initial medical examination consisted of taking an anamnesis, analysing medical documentation (if the persons deprived of liberty had any with them), measuring height and weight, assessing mental state, measuring blood pressure, and performing a basic physical examination. Previously, as part of the first medical examination upon arrival at the prison, routine chest X-rays were performed; however, that practice had been abandoned several years previously owing to a lack of material resources. Fluorography campaigns had been organised in 2010 and 2011 in cooperation with the anti ‑ tuberculosis dispensary (see p. 141 of that report). 46.     On the day of the visit by the NPM team there were six convicted persons with tuberculosis at the prison, according to the statistics of the prison medical team (see p. 156 of that report).     Helsinki Committee for Human Rights in Serbia ( Helsinški odbor za ljudska prava u Srbiji )      Prisons in Serbia July-October 2010 (Zatvori u Srbiji jul-oktobar 2010), March 2011 47 .     This NGO visited Sremska Mitrovica Prison on 27 and 28   October 2010. The report indicated that several buildings had been built or reconstructed since the previous visit in 2005. It was stated that the “Enhanced Supervision Department” had been renovated after it had been damaged during a prison riot in 2006. At the time of the visit that department accommodated prisoners in solitary confinement who used to be accommodated in the second wing (see p. 4 of that report). The report indicated that the cells used for enhanced supervision, which accommodated two prisoners, as well as those for solitary confinement, were in good material condition. 48.     It was reported that a lecture on tuberculosis was planned as part of a preventive screening campaign covering all institutions within the penal system. Furthermore, all institutions were to be visited by a bus equipped with a device for lung imaging. The imaging would be voluntary and, after the scans had been reviewed and suspicious cases identified, prisoners would be invited for additional tests and, if necessary, further treatment. At the time of the NGO’s visit, the bus was present at Sremska Mitrovica Prison. Prisoners, sorted by their prison wing, were brought to the bus according to a schedule, where they spoke with medical staff and stated whether they agreed to the proposed diagnostic procedure (see p. 7 of that report).      Prison System in Serbia in 2011, March 2012 49 .     It was reported that a lung X-ray of convicted persons during the initial medical examination was done upon indication (see p. 53 of that report).    Other relevant information 50 .     A report titled “Comparative analysis of the implementation of tuberculosis prevention and control programs in 2017 in relation to the previous five years” ( Komparativna analiza realizacije programa prevencije i kontrole tuberkuloze tokom 2017. godine u odnosu na prethodnih 5 godina ), published by the Institute of Public Health of Serbia ( Institut za javno zdravlje Srbije „Dr Milan Jovanović Batut“ ), stated that the tuberculosis incidence in the prison population in Serbia (per 100,000 prisoners) had been 70 in 2007, 42 in 2008, 24 in 2009 and 39 in 2010 (the total numbers of prisoners diagnosed with tuberculosis for those years were 21, 14, 8, and 13 respectively and the total number of prisoners in 2007 had been 9,000; see paragraph   53 below).       RELEVANT INTERNATIONAL DOCUMENTS AND REPORTS    Reports of the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) on visits to Serbia      Report on the visit to Serbia and Montenegro carried out from 16 to 28   September 2004, CPT/Inf (2006) 18 51 .     The CPT delegation observed that the cells in the second wing of Sremska Mitrovica Prison lacked adequate levels of natural light and that they were overcrowded (see paragraph 97 of that report). As regards the disciplinary cells, it was noted that they were equipped with only a wooden platform (with a mattress and bedding), a box for personal belongings, a sink and a squat toilet, and that levels of natural light and artificial lighting were at best mediocre (see paragraph 133 of that report). 52 .     Paragraph 163 of the report highlighted the re-emergence of tuberculosis within the Serbian prison system and noted the absence of a systematic screening procedure upon arrival. That deficiency, combined with other contributing factors, posed a serious risk to the health of both the prison population and the wider community.      Report on the visit carried out from 19 to 29 November 2007, CPT/Inf (2009) 1; Response of the Government of Serbia of 14 January 2009, CPT/Inf (2009) 2 53 .     At the time of the visit, the total number of prisoners in Serbia stood at 9,000 (see paragraph 39 of that report). 54 .     Sremska Mitrovica Prison was undergoing major renovation works at the relevant time. The CPT noted that the conditions in the second wing remained as poor as those observed during the 2004 visit (see paragraph   51 above). That wing accommodated, among others, prisoners in solitary confinement for disciplinary reasons, and the cells were found to be dilapidated, dirty and overcrowded (see paragraph 51 of that report). The CPT recommended that steps be taken to refurbish, as a matter of priority, the cells in the second wing (see paragraph 53 of that report). 55 .     The report indicated in paragraph 51 that the third wing, which had been refurbished, had a part of it reserved for prisoners identified as posing a security risk, prisoners segregated for their own safety and for those serving disciplinary sanctions. It further stated that those cells measured 10 sq. m and were accommodating two prisoners each, that they were well lit and ventilated, and they were in an excellent state of repair and cleanliness. 56.     The Government informed the CPT that the second wing would be refurbished in 2009 and that prisoners from the second wing would be placed in a new facility that was initially supposed to have been a reception department (see paragraph 44 of the Government’s Response). 57 .     The CPT observed that there had been delays of up to nine days in the conduct of initial medical examinations at Sremska Mitrovica Prison. Furthermore, the medical examination upon arrival appeared to be cursory, consisting merely of asking the prisoners questions about their previous diseases and taking their pulse and blood pressure. It was recommended to take steps to ensure that medical examinations on arrival should be comprehensive and include appropriate screening for transmissible diseases (see paragraph 72 of that report). In paragraph 75 of the report it was stated that the CPT had been informed by officials from the Ministry of Health that tuberculosis was no longer an issue of concern. 58 .     The Government stated that the failure to conduct the initial medical examination without delay at Sremska Mitrovica Prison had occurred only once and had not been repeated (see paragraph 66bis of the Government’s Response). Furthermore, it was stated that a strategy for combating transmissible diseases in prisons had been developed. In 2007 the OSCE Mission in Belgrade had organised training for prison staff all over Serbia. Brochures had been published on preventing the transmission of infectious diseases and distributed to all prisons in Serbia. Further, pertinent training of staff employed in Serbian prisons had also been conducted in collaboration with the United Nations.      Report on the visit carried out from 1 to 11 February 2011, CPT/Inf (2012) 17; Response of the Government of Serbia of 14 June 2012, CPT/Inf (2012) 18 59 .     The CPT did not visit Sremska Mitrovica Prison in 2011. As for the prison institutions it did visit, it remarked that medical examinations on arrival remained superficial, consisting merely of an interview, and that there were no paraclinical referrals. It recommended that the medical examination on arrival should be comprehensive, including appropriate screening for transmissible diseases (see paragraph 73 of that report). 60.     In their response, the Government of Serbia submitted that, upon the arrival of new prisoners, medical staff collect information from detainees regarding any current or past illnesses and related treatment, previous injuries or surgical interventions, use of psychoactive substances and potential withdrawal symptoms, as well as any psychiatric treatment received (see p.   21 of that document).      Report on the visit carried out from 26 May to 5 June 2015, CPT/Inf (2016) 21; Response of the Government of Serbia of 24 June 2016, CPT/Inf (2016) 22 61 .     The CPT carried out visits to several penal establishments, including Sremska Mitrovica Prison. It observed that screening for tuberculosis upon arrival was being performed at the Niš Correctional Institution and noted that all facilities appeared to have an accurate overview of the number of prisoners affected by transmissible diseases (see paragraph 79 of the report). At the same time, the CPT reiterated its earlier findings that the medical examination of newly arrived detainees remained superficial, being limited to an interview without any physical examination. It therefore recommended that the medical screening on arrival be comprehensive and include appropriate screening for transmissible diseases (see paragraph 81 of the report). 62.     In their response, the Government indicated that all recommendations of the CPT would be applied by the health service of the Sremska Mitrovica Prison (see p. 21 of that document).      Report on the visit carried out from 31 May to 7 June 2017, CPT/Inf (2018) 21 63 .     The CPT did not visit Sremska Mitrovica Prison. As regards screening for tuberculosis, it was again stated that such a practice existed at Niš Correctional Institution and that all establishments appeared to have an accurate picture of the number of prisoners affected by transmissible diseases (see paragraph 58 of that report).      Report on the visit carried out from 9 to 19 March 2021, CPT/Inf (2022) 03 64 .     The CPT did not visit Sremska Mitrovica Prison. In reference to other establishments visited, the following was stated (references omitted): “86. The medical examination of newly admitted prisoners consisted of a physical check and anamnesis which included a questionnaire for the screening of infectious and transmissible diseases (i.e. Tuberculosis, HIV, and Hepatitis C), a risk assessment for the prevention of suicide and self-harming. That said, despite the very high prevalence of peopl