The Covid-19 epidemic is an opportunity to underline how prison health on the African continent remains a weak link of the prison system. Beyond the difficulties in caring for Covid-19 in detention, prison infirmaries, where they exist, are rarely integrated into the health system in practice. Administrations provide little for the vital needs of prisoners. Dietary deficiencies are frequent, skin diseases recurrent and prisoners are most often dependent on the financial means of their families or NGOs when it comes to access to health care. The social illegitimacy of the prison population and the reluctance of States to offer convicted prisoners what they do not guarantee to the general population are two arguments put forward to justify what amounts to necropolitics. At the same time, international actors working in prisons essentially target pathologies with epidemic potential, constrained by funding sources (UNAIDS, Global Fund) supporting population-wide health strategies. Here we would like to return to these two logics and develop an argument for a decompartmentalized approach to prison health. Beyond the recognition of individual health experience and epidemiological concerns, addressing prison health globally contributes to the restoration of prisoners' dignity and rights by the State, a necessary condition for the maintenance of citizenship beyond confinement.