6.  The applicant was born in 1971 and is currently serving sentences of life imprisonment and 15 years’ imprisonment in Peqin High Security Prison (Albania). 7.  On 6 October 1997 the Italian authorities issued an arrest warrant in respect of the applicant, charging him with the premeditated homicide of an Albanian national in Milan, Italy. 8.  On 2 February 2001 the applicant was sentenced in absentia to life imprisonment by the Milan Assize Court of Appeal on a count of murder and to five years’ imprisonment on a count of illegal possession of firearms. 9.  On 16 February 2001 the Italian authorities issued a second arrest warrant concerning the applicant which related to a new charge against him, namely participation in a criminal organisation and international narcotics trafficking. From the documents in the file it transpires that during the period of the proceedings before the Italian courts the applicant was carrying on a lawful business and resided in Albania. 10.  On 29 April 2001 Interpol Albania transmitted to the Tirana Police the two arrest warrants mentioned above. On the same date the Chief of the Tirana Criminal Police ordered that “the arrest warrants be immediately enforced”. 11.  On 30 April 2001 Interpol Rome sent a fax to the Albanian authorities seeking the initiation of criminal proceedings against the applicant for crimes committed on Italian territory. 12.  On 30 April 2001 the applicant was arrested in Albania on the strength of the arrest warrant issued on 16 February 2001 by the investigating judge at the Milan Court of Appeal. The charge related to the applicant’s involvement in a criminal organisation and international drug trafficking. 13.  On 1 May 2001 the applicant was remanded in detention for 15 days. 14.  On 12 May 2001 the Tirana District Court, (“the District Court”), dismissed an appeal by the applicant against the grounds of his arrest. On the same day, the prosecutor informed the applicant about the charges against him, namely participation in a criminal organisation and international narcotics trafficking. 15.  On 15 May 2001 the District Court upheld the prosecutor’s application and ordered the applicant’s detention in prison for an undetermined period. On 4 June 2001 the Supreme Court upheld the decision. 16.  In June and December 2001 the General Prosecutor’s Office repeatedly requested the Italian authorities to transmit the evidence that grounded the charges against the applicant. In January 2002 the request was also repeated by the Albanian Minister of Justice. 17.  On 30 July 2002 the General Prosecutor’s Office instituted criminal proceedings in the Tirana District Court, charging the applicant with international narcotics trafficking (hereinafter “the criminal proceedings”). 18.  On 29 December 2003 the District Court found the applicant guilty of establishing a criminal organisation and international narcotics trafficking and sentenced him to 19 years’ imprisonment. According to the applicant, the conviction related to a new charge of which he had never been informed. On 25 June 2004 the Tirana Court of Appeal, (“the Court of Appeal”), upheld the District Court’s judgment but changed the applicant’s sentence to 17 years’ imprisonment. The applicant appealed to the Supreme Court. On 23 June 2006 the Supreme Court changed the qualification of one of the criminal offences of which the applicant had been convicted. It upheld the Court of Appeal’s judgment and changed the applicant’s sentence to 15 years’ imprisonment. A constitutional complaint by the applicant to the Constitutional Court against the above-mentioned judgments is still pending. 19.  On 21 February 2002, while the applicant was in detention on remand on the charges of participation in a criminal organisation and international narcotics trafficking (see paragraph 12 above), the Milan public prosecutor’s office asked the Italian Ministry of Justice to request the Albanian authorities to validate in Albania the sentence imposed on the applicant by the Milan Assize Court of Appeal on 2 February 2001, which had become final on 30 January 2002. 20.  On 28 March 2002 the Italian Ministry of Justice, among other things, informed the Milan public prosecutor’s office that the Italian authorities could not seek the validation and enforcement in Albania of a criminal judgment delivered by the Italian courts, in view of the fact that neither country was party to any international agreement on the matter. On the same day the Italian Ministry of Justice transmitted the above-mentioned judgment, for information purposes, to the Albanian Embassy in Rome. 21.  On 8 April 2002 the Albanian Embassy in Rome, in a letter with the misleading heading “Transfer of an Albanian national currently detained in Italy”, informed the Albanian Government of the “request for extradition” by the Italian Ministry of Justice concerning the applicant, who, according to the Embassy’s letter, was “serving a sentence in Italy”. 22.  On 23 April 2002 the Governments of Italy and Albania signed an agreement for the transfer of sentenced persons, which was ratified by the respective parliaments in 2003 and 2004. 23.  On 3 May 2002 the Albanian Ministry of Justice, under Article 512 of the Albanian Code of Criminal Procedure (“the CCP”), requested the General Prosecutor’s Office to institute proceedings for the validation and enforcement in Albania of the judgment concerning the applicant delivered by the Italian court. 24.  On 15 May 2002 the District Court, in a single-judge panel, ordered the applicant’s detention pending the proceedings for the validation and enforcement in Albania of the Milan Assize Court of Appeal’s judgment of 2 February 2001. The applicant was served with the decision while he was in detention in connection with the criminal proceedings referred to above (see paragraphs 17-18 above). 25.  On 10 May 2002, under Articles 512 and 514 of the CCP, the General Prosecutor’s Office initiated proceedings before the District Court for the validation and enforcement in Albania of the judgment delivered by the Milan Assize Court of Appeal (hereinafter “the validation and enforcement proceedings”). 26.  According to the applicant’s submissions to the District Court in May 2002, Article 514 of the CCP required, inter alia, his consent for the validation and enforcement in Albania of the Milan Assize Court of Appeal’s judgment, which consent he decided not to give (see paragraph 85 below). 27.  On 13 June 2002 Parliament adopted amendments to the provisions of the Code of Criminal Procedure, which, inter alia, repealed the requirement of the detainee’s consent provided for in point (e) of Article 514 of the CCP (see paragraph 86 below). 28.  On 17 June 2002 the General Prosecutor filed further observations with the District Court, pointing out, among other things:
“...in spite of the fact that the consent of the sentenced person is required by Article 514 (e) of the CCP for the validity in Albania of a sentence imposed by a foreign authority, this should be interpreted only in circumstances involving the transfer of sentenced persons and not in such a manner as to hinder the course of justice. Moreover, Parliament, by Law no. 8813 of 13 June 2002, abrogated point (e) of Article 514 of the CCP...” 29.  On 20 June 2002 the District Court rejected the General Prosecutor’s request as not being in compliance with the requirement in Article 514, point (e), of the CCP. The court held:
“...the requirement laid down in Article 514, point (e), of the CCP is necessary for the validity and enforcement in Albania of a sentence imposed by a foreign authority in accordance with the Convention on the Transfer of Sentenced Persons and the provisions of domestic law. In accordance with the wording of the above-mentioned Article, the consent of sentenced persons is required without any distinction between the circumstances of the transfer of detainees or the validity of the sentence imposed by a foreign court. Moreover, Law no. 8813 of 13 June 2002, which abrogates point (e) of Article 514, is not applicable in the present case since it has not come into force for the time being ...” 30.  On 24 July 2002 the Court of Appeal dismissed an appeal by the General Prosecutor. The court upheld the reasoning set out in the District Court’s judgment and held that Law no. 8813 of 13 June 2002 could not be applicable retroactively on the ground that it would have resulted in more severe provisions being applied to the applicant’s detriment. 31.  On an unspecified date in 2002 the General Prosecutor lodged an appeal with the Supreme Court (Criminal Division) against the Court of Appeal’s judgment. 32.  On 29 October 2002, in order to harmonise and amend the courts’ practice (për unifikimin dhe ndryshimin e praktikës gjyqësore), the President of the Supreme Court relinquished jurisdiction in favour of the Supreme Court’s Joint Benches. 33.  On 30 January 2003 the Supreme Court, Joint Benches, quashed the judgments of the Court of Appeal and the District Court and remitted the case for fresh consideration to the District Court. In its judgment, the Supreme Court interpreted provisions of the CCP relating to extradition, the transfer of sentenced persons and the validity and enforcement in Albania of sentences imposed by foreign courts, giving its definition from the standpoint of international law principles and inter-State cooperation. The court held that in circumstances where no ruling could be given on a specific issue because the relevant provisions were inadequate, a legal basis could be provided by international customs, namely the principle of good will and reciprocity, and treaties. In the present case, finding that the requirement laid down in Article 514, point (e), of the CCP was inadequate, it considered that the European Convention on the International Validity of Criminal Judgments and the European Convention on the Transfer of Sentenced Persons provided a sufficient basis for the validation and enforcement in Albania of the Milan Assize Court of Appeal’s judgment. 34.   The judgment stated, in so far as relevant, the following:
“The transfer of sentenced persons has been regulated by the European Convention on the Transfer of Sentenced Persons as ratified by the Parliament of the Republic of Albania and published in the Official Journal no. 22 of 1999 (...). The European Convention on the International Validity of Criminal Judgments has been signed but not yet ratified by the Parliament. As such, this Convention cannot be considered a constituent part of the domestic legal corpus and is not directly applicable. However, its signature and the approval of the engaging provision according to which the State recognises and respects the generally recognised norms and principles of the international law, guide us to understand, interpret and justly apply the provisions of the CCP at issue.
(...)
In the case of validity and enforcement of a foreign criminal judgment, the reference to and the solution of the case in accordance with point (e) of Article 514 of the CCP, at the material time, would be nonsense. Were the court to regard the consent of the sentenced person as essential, that would lead to an ad literam interpretation of the provision, as applied by the District Court and the Court of Appeal. However, the interpretation of a legal provision is rather complex. In the event the ad literam interpretation leads to an absurdity [nonsense], a logical and systemic interpretation prevails. According to this interpretation, the said provision shall be interpreted in a reasonable manner. This means that the notion of “the consent of the sentenced person” cannot be broadly interpreted. It should be narrowly interpreted so as not to lead to an absurdity, which would be the case, were the appellant to give his consent to serve the criminal sentence in his country. As it transpires from the acts, the appellant was tried in absentia since he absconded from the Italian justice.
 (...)
The consent of a person sentenced by a foreign court is a sine qua non for the determination of the question whether the sentence is served in the sentencing State or in the detainee’s country of origin, that is in the prisons of the country of which he is a citizen [emphasis added in the original text].
(...)
This decision of the Supreme Court, Joint Benches, finally resolves the problem, holding that the lack of consent by the sentenced person for the validation of a foreign criminal judgment is not an obstacle for the Albanian courts to proceed with such a validation and recognition [emphasis added in the original text].
During the examination of the case, the appellant’s counsel stated that there is no bilateral agreement between Albania and Italy as regards the validity and enforcement of criminal judgments. They maintained that such an act would impinge upon the sovereignty of the Albanian state, which is exercised by the Parliament through the ratification of an international or bilateral agreement. This claim is unfounded. The Albanian Parliament manifested its sovereign will through the enactment of the CCP, whose provisions at issue should be applied in accordance with their meaning and the unified interpretation of the Supreme Court as outlined above.
It must be underlined that in the absence of signed and ratified instruments, the generally recognised norms of the international law may apply in accordance with the principle of good will and reciprocity. Pursuant to the CCP, the Ministry of Justice is responsible for jurisdictional relations with foreign authorities, including the Italians.
According to Article 512 of the CPP, it is within the discretion of the said Ministry as a manifestation of the political will of the Albanian State, to request the validation before a court of a foreign judgment. The Court shall not examine this kind of discretion. It shall only examine whether the request has been made by the competent authority in accordance with the law and whether the documentation is complete.” 35.  In the retrial proceedings before the District Court, the applicant claimed that there had been no request by the Italian authorities for the validation of the Italian criminal judgment against him, having also regard to the Italian authorities’ letter of 28 March 2000 (see paragraph 20 above). Furthermore, he added that there was no bilateral agreement between the two States for such a validation to take effect. The applicant also relied on the fact that he had not given his consent for the validation. 36.  On 20 May 2003 the District Court, sitting as a bench of three judges, relied entirely on the judgment of the Supreme Court of 30 January 2003. It held that the sentence imposed by the Milan Assize Court of Appeal was compatible with the provisions of the Albanian CCP as amended by Law no. 8813 of 13 June 2002. It ruled that the applicant should serve cumulative sentence of life imprisonment in Albania on a count of murder and a count of illegal possession of firearms. 37.  The presiding judge, E.K., expressed a partly dissenting opinion on the above-mentioned judgment, reminding the court that the relevant statutory provisions laid down a maximum penalty of 25 years’ imprisonment instead of life imprisonment as imposed in the applicant’s case. 38.  According to the applicant’s submissions in the present proceedings before the Court, the District Court applied those parts of Law no. 8813 of 13 June 2002 that contributed to the aggravation of his situation. Moreover, in accordance with Article 13 of the CCP as amended by the above-mentioned Law, the court should have sat in a single-judge formation in his case. Furthermore, he maintained that, having regard also to Judge E.K.’s dissenting opinion, the composition of the bench could have influenced the outcome of the proceedings. 39.  On an unspecified date in 2003 the applicant filed an appeal, invoking the same grounds as he did before the District Court. 40.  On 10 September 2003 the Court of Appeal dismissed the appeal and upheld the District Court’s judgment, fully relying on the Supreme Court’s judgment of 30 January 2003. 41.  The applicant noted that at the last hearing of the appeal proceedings, Judge Sh.B., who had presided over the trial until that moment, had been substituted by Judge D.B. without a formal decision. 42.  The applicant produced to the Court two Court of Appeal judgments which have the same text but were delivered by two different benches: the first by a bench presided over by Sh.B. and the second by another bench presided over by D.B. 43.  On 9 October 2003 the applicant lodged an appeal with the Supreme Court. He relied on almost the same grounds of appeal as he did before the District Court and the Court of Appeal. Moreover, the applicant challenged the application of the generally recognised norms of international law as inadequate and imprecise. 44.  On 30 January 2004 the Supreme Court dismissed the applicant’s appeal as the grounds of appeal fell outside the scope of Articles 432 and 448 § 2 of the CCP (see paragraphs 82 and 83 below). 45.  In April 2004 the applicant appealed to the Constitutional Court challenging the Supreme Court’s judgments of 30 January 2003 and 30 January 2004. He alleged that the proceedings had been unfair in various respects. In particular, he complained that the criminal proceedings had been in breach of the CCP’s requirements as laid down in Articles 13 (composition of courts), 514 (sentenced persons’ consent) and 512 (for the validation and enforcement in Albania of a sentence imposed by a foreign authority, a request addressed by the foreign authority and a valid international and/or bilateral agreement had to be in force in both countries). The applicant maintained that no request for the validation of the sentence had been addressed by the Italian authorities to the Albanian Minister of Justice, nor had there been any international convention in force between the countries at the material time. 46.  On 12 July 2004 the Constitutional Court dismissed the applicant’s appeal. It found the Supreme Court’s judgments of 30 January 2003 and 30 January 2004 constitutional. Moreover, it held that even though the composition of the District Court’s bench of 20 May 2003 was in breach of the law, it did not render the process unconstitutional as a whole. As regards the existence of two judgments delivered by different benches of the Court of Appeal on 10 September 2003, the Constitutional Court noted that there was only one judgment in the case file, which corresponded to the bench that had decided the case. 47.  The judgment stated, in so far as relevant, as follows:
“The Constitutional Court considers that the arguments raised in the Supreme Court’s, Joint Benches, judgment [of 30 January 2003] are not in breach of the Constitution or [international] conventions. The mutual recognition [validation] of court judgments serves to strengthen legal cooperation between States and the achievement of certain objectives in relation to the freedom of liberty, security and justice. The principle of reciprocity presupposes the application of mutual and legal instruments in inter-state relations. In international law, reciprocity is defined as the right to equality and mutual respect amongst countries. International criminal doctrine and case-law have confirmed that cooperation amongst countries can occur even in the absence of bilateral treaties, on the basis of the principle of reciprocity.
As a rule, the principle of reciprocity applies through international instruments such as treaties and agreements, which envisage mutual rights and obligations. But, in exceptional cases, in the absence of such agreements, the States are not precluded from directly applying the principle of reciprocity, the generally recognised norms of international law and good will. Their application is in the interest of strengthening the States’ cooperation in the fight against organised crime and criminality.
The Constitutional Court notes that the judgment of the Supreme Court, Joint Benches as regards Articles 512 and 514 is not unconstitutional. They [the Supreme Court] rightly concluded that there was no conflict between those provisions and the international conventions’ provisions. The domestic provisions should apply in accordance with the interpretation made by the [Supreme Court] Joint Benches.
(...) It may be understood (...) that the request for the validation of a foreign court judgment may be made even in the absence of an agreement, on the basis of good will, generally recognised norms and the principle of reciprocity.” 48.  On 24 September 2003, 13 January 2004 and 16 February 2004, in view of the deterioration in the applicant’s health, his representative and his father requested the Ministry of Justice and the prison authorities to allow him to be examined by appropriate doctors. 49.  From 23 August 2004 to 31 August 2004 the applicant underwent in-patient treatment and examinations at Tirana Prison Hospital. During that period an initial magnetic resonance imaging (MRI) scan was carried out. He was diagnosed as suffering from multiple sclerosis (MS). The doctors reported that, even when the disease was quickly detected and treated, it was capable of causing shock, organ damage, permanent disability or death. 50.  On 29 September 2004 a second MRI scan was carried out. 51.  On 5 October 2004 the applicant’s representative informed the Registry that the applicant’s state of health had deteriorated and that he consequently needed further treatment and an essential medical examination by specialist neurologists. He filed two reports regarding the applicant’s state of health, which the doctors reported had worsened. 52.  On 7 January 2005 Tirana High Security Prison requested authorisation from the Tirana prosecutor’s office for medical examinations at Tirana Prison Hospital in respect of the applicant and eight other inmates. 53.  On an unspecified date in January 2005 the Tirana prosecutor’s office gave its approval in relation to the other eight prisoners and rejected the request concerning the applicant, stating that it was not competent to rule on his transfer from prison. It designated the General Prosecutor’s Office as the competent authority. 54.  On 13 January 2005 Tirana High Security Prison reiterated its request to the General Prosecutor’s Office concerning the applicant’s medical treatment, but received no response. On 17 January 2005 the prison requested the Ministry of Justice’s General Prison Unit to designate the competent authority to decide on the applicant’s transfer for medical purposes. 55.  On 16 February 2005 the applicant initiated criminal proceedings against the Tirana prosecutor’s office, complaining that its neglect in ensuring his medical care had contributed to the worsening of his health, which constituted discrimination vis-à-vis those prisoners who had been allowed to have medical treatment. 56.  On 26 February 2005 the applicant was transferred to Peqin Prison, a high-security prison located approximately 100 km from Tirana Prison Hospital and detained under a high-security regime. 57.  From February 2005 onwards the applicant was refused the opportunity to meet his lawyers and have any other contact with them. 58.  On 15 April 2005, following repeated requests by the doctors of Peqin Prison, the applicant was sent to Tirana Prison Hospital for a medical examination. Following consultations among the doctors of that hospital and Tirana Civil Hospital on 19 April 2005, the applicant’s diagnosis was confirmed and they concluded that it was imperative for his health that he be treated with interferon-beta. 59.  In a letter of 23 May 2005 the applicant’s representative informed the Registry that from April 2005 the prison authorities had suspended the applicant’s medical treatment, contrary to the doctors’ opinions, and that he was treated with vitamins and anti-depressant drugs. 60.  In a letter of 28 June 2005 the applicant’s representative informed the Registry that without a court decision, the applicant had been placed under the special prison regime provided for in section 43 of the Prisoners’ Regime Act, which derogated from the conditions for ordinary detention laid down in the Act. 61.  On 4 November 2005, following persistent requests by the applicant, the General Directorate of Prisons assessed him and reported on the medical treatment he was being given, finding that he was being treated mainly with drugs prescribed to cure rheumatism. 62.  In 2005 the applicant initiated several sets of criminal proceedings against the Head of Tirana Prison Hospital, complaining of negligence in the provision of medical care to him. On unspecified dates the General Prosecutor’s Office dismissed his applications, and appeals by the applicant against the prosecutor’s decisions are still pending before the domestic courts. 63.  From 21 to 24 February 2006 the doctors confirmed that the applicant suffered from multiple sclerosis. They reported deterioration in the applicant’s health, caused by the total lack of medical treatment for over two years. Fearing for his life, they strictly recommended that the applicant immediately receive adequate medical treatment. 64.  In response to the applicant’s request of 3 January 2008, the President of the Chamber decided, on 10 January 2008, to indicate to the Albanian Government an interim measure under Rule 39 of the Rules of Court, stating that “the applicant should immediately be transferred to a civilian hospital in order that a medical examination of his condition can be carried out and that he can be given the treatment appropriate to his condition.” The President also decided to request the Government to immediately inform the Court of any decision to retransfer the applicant to Peqin High Security Prison, attaching any relevant medical certificate supporting his retransfer. 65.  In the afternoon of 10 January 2008, given that it was the first time that an interim measure was being applied in respect of Albania, the Registrar of the Fourth Section, (“the Registrar”), spoke to the Government’s Agent over the telephone and officially notified the content of the interim measure and the importance of complying therewith. The Government’s Agent was informed that a copy of the notification of the indication under Rule 39 would be subsequently sent by facsimile. 66.  Several attempts to send the notification by facsimile were unsuccessful in the evening of 10 January 2008. On the morning of 11 January 2008, having regard to the recurring problem with the facsimile, a scanned copy of the notification was sent by electronic mail to the Government Agent who acknowledged receipt thereof (also via electronic mail). On the same morning, the Government’s Agent informed the Court in a telephone conversation that she had urgently contacted the Ministry of Justice, the Ministry of Health, the General Prosecutor’s Office and other responsible state institutions in order to comply with the Court’s interim measure. In their written submissions, the Government confirmed the above statement. 67.  From 11 January to 22 January 2008 the Government did not provide any information concerning any measures taken to comply with the Court’s interim measure of 10 January 2008. 68.  On 23 January 2008 the applicant informed the Court that he had not yet been transferred. 69.  On 24 January 2008 the applicant’s letter was forwarded to the Government, drawing their attention to the fact that a failure to comply with an interim measure could give rise to a violation of Article 34 of the Convention. 70.  On 25 January 2008, following an order of the General Directorate of Prisons, the applicant was transferred to Tirana Prison Hospital with a view to being taken to hospital for the conduct of medical examinations. On the same day the applicant refused to be transferred to hospital and started a hunger strike. He alleged that the authorities had to provide him with the appropriate treatment instead of conducting medical examinations. 71.  On 28 January 2008, the Registrar made several calls to the applicant’s representative and to the Government Agent. The Registrar urged the applicant to end the hunger strike and to comply with the Court’s interim measure about his transfer to hospital, where a medical examination of his situation would be conducted. The Registrar also called upon the authorities to comply with the Court’s interim measure and to refrain from any use of force, as alleged by the applicant. 72.  On the same day, the applicant was transferred to the neurology ward of Tirana University Hospital Centre’s (Qendra Spitalore Universitare – “the UHC”) where he had specialised medical examination. 73.  On 29 January 2008, following a letter of the UHC that the applicant’s presence was no longer required, the applicant was transferred to Tirana Prison Hospital. 74.  On 30 January 2008 the Government provided the Court with a copy of the applicant’s medical file following the medical examinations of 28 January 2008. A doctors’ panel had concluded that the applicant suffered from multiple sclerosis. The doctors’ panel recommended that the applicant be treated with interferon beta with a view to stabilising his health and preventing progression of the disease. The doctors were unable to accurately describe the progression of the disease over the years, as he had not been under medical care. They expressed the view that the applicant’s health did not present any urgency and, under these circumstances, patients were usually treated as out-patients without any need to be hospitalised. 75.  On 14 July 2008 the Government confirmed that the applicant’s treatment with interferon beta had started on 17 June 2008 in accordance with the doctors’ panel’s conclusions. The treatment was being administered every other day and it would appear that the applicant’s health has been stable ever since. 76.  On 16 September 2008 the President of the Chamber decided to refuse the applicant’s request for the application of a renewed Rule 39 indication. The Government, however, were requested “to inform the Court on a regular basis about the applicant’s state of health and to provide medical evidence of this, bearing in mind that the applicant’s health conditions may necessitate specialised assistance while in prison.” 77.  On 12 March 2009 the Government informed the Court that the applicant has been regularly provided with interferon beta and other medicines appropriate to his health.