According to a report from the United States Department of State on human rights in Tajikistan, citizens are denied many of their rights and have limited ability to change the system of government. The report found this to be especially true in the case of prisoners, whose access to basic Human Rights was inadequate: there have been reports of torture, threats, and abuse of prisoners and detainees by security forces due, in part, to their ability to act with impunity. The denial of the right to a fair trial for those who stand accused of a crime has been identified as another issue, which can often contribute to harsh and life-threatening prison conditions as well as the blocking of international access to Tajikistan prisons. Pre-trial detention is typically longer than needed, and court proceeding are controlled by the prosecution. Prisons are overcrowded, and the incidence of tuberculosis and malnutrition is high among inmates.