UZBEKISTAN: LONG-TIME MINISTER OF HEALTH SACKED

C O N F I D E N T I A L SECTION 01 OF 02 TASHKENT 000703 SIPDIS AMEMBASSY HELSINKI PASS TO AMCONSUL ST PETERSBURG AMEMBASSY MOSCOW PASS TO AMCONSUL VLADIVOSTOK AMEMBASSY MOSCOW PASS TO AMCONSUL YEKATERINBURG AMEMBASSY BELGRADE PASS TO AMEMBASSY PODGORICA AMEMBASSY ATHENS PASS TO AMCONSUL THESSALONIKI E.O. 12958: DECL: 2019/05/11 TAGS: PGOV PINR SOCI KCOR UZ SUBJECT: UZBEKISTAN: LONG-TIME MINISTER OF HEALTH SACKED CLASSIFIED BY: Timothy P. Buckley, Second Secretary, Department of State, Political and Economic Section; REASON: 1.4(B),(D) ¶1. (C) Summary: On April 23, President Karimov relieved long-time Minister of Health Feruz Nazirov from his duties and appointed Adkham Ilkhamovich Ikramov, who had been serving as First Deputy Minister of Health, as his replacement. Reportedly, Nazirov was fired due to unsatisfactory work in HIV prevention and poor development of medical services in rural areas of the country. There were also allegations of widespread corruption. End summary. Longest Serving Minister Gets the Boot -------------- --- ¶2. (C) Karimov sacked Health Minister Nazirov on April 23 without much fanfare, in contrast to the high-profile criticisms he often levels at deposed provincial governors (hokims) for poor performance. Nazirov had been the incumbent since November 23, 1998, which made him the longest serving Minister, according to our LES Political Assistant (Minister of Foreign Economic Relations Ganiev has perhaps held Minister-level rank for a longer period but served in different positions along the way). It was widely believed that newly-appointed Minister Ikramov, who served as First Deputy Minister of Health since November, 2007, was groomed to eventually succeed Nazirov. Thus, at first glance, it could have just been time for a change. Connected to Prime Minister -------------- ¶3. (C) According to our Political Assistant, Nazirov was believed to be particularly corrupt but enjoyed a close relationship with and the patronage of Prime Minister Mirziyayev. This may have afforded Nazirov added job security over the years and insulated him from official criticism. A possible scenario leading to the firing is that some officials went around Prime Minister Mirziyayev to the President or it is possible that Karimov himself had finally gotten too much of an earful about the poor medical care available in the provinces, which could ultimately add to popular discontent. Our Political Assistant believes that Mirziyayev would not step up and defend his friend Nazirov or challenge Karimov's decision, especially since Nazirov had logged 11 years on the job. Doubtless, Nazirov himself was an astute political player and knew how to keep himself afloat. Emboffs with frequent interaction with the Ministry of Health reported that Nazirov was readily accessible when times were good but hard to pin down during rough patches in the bilateral relationship. Nazirov Will Not be Missed in the Villages -------------- -------------- ¶4. (C) Our Political Assistant regularly accompanies his ailing father to medical appointments several times per month, which presents a chance for him to interact with average citizens from different parts of the country who travel to the capital for health care. He also converses with clinic employees, none of whom are aware he works for the Embassy. These Uzbeks tell a consistent story of dissatisfaction with poorly developed medical services in the small towns, and anger with Nazirov because they knew that the state budget called for investment to improve local clinics over a period of several years and they saw no changes. Our Political Assistant also learned that Nazirov came under fire within the government for poor performance on HIV prevention over the years. Our Political Assistant also spoke with several doctors from the provinces who alleged that local clinic directors would regularly hand over an envelope with money to Nazirov in his car TASHKENT 00000703 002 OF 002 whenever he visited or inspected a health facility. Our LES noted that the Ministry of Health is particularly prone to corruption because it controls access to health services, medicines, equipment, and also is a recipient of international donor funds. Bio Notes on New Minister Ikramov -------------- ¶5. (C) Before his appointment as First Deputy Health Minister in 2007, Ikramov successively served as chief of the radiology laboratory, chief of the ultrasound lab, and the Deputy Director of the Vokhidov Specialized Surgery Center. He completed a dissertation entitled "Complex Radiation Diagnosis and Choice of the Method of Surgical Treatment of the Echinococcosus of the Liver and Lungs." An embassy officer who previously met with Ikramov found him to be young and sharp, and there is thus potential for him to be a reasonable interlocutor; however it remains to be seen whether Ikramov will implement improved medical service delivery for the populace. Interestingly, Ikramov was scheduled to participate in an INL-sponsored study tour to a forensic laboratory and to participate in a conference in the U.S. in February, but the government cancelled his participation shortly before the trip without explanation. It is possible that this change was already in the pipeline and that the Government of Uzbekistan did not want a newly-minted minister to have had recent official contact in the U.S. Comment: -------------- ¶6. (C) Nazirov's firing comes amid renewed speculation that jousting is underway at the top of Uzbekistan's power structure. According to unverifiable Internet commentary, various forces including First Daughter Gulnara Karimova and Prime Minister Mirziyayev are positioning themselves behind the scenes to succeed Karimov if anything happens to the Uzbek President. So far none of this speculation amounts to anything, but it is a reminder that Karimov's number one, and thus far unresolved, priority is to secure a stable transition process for his anointed successor. NORLAND