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