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'Arbitary rule by whim' alive in #Turkmenistan

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Government officials finding themselves in post one day and indefinitely imprisoned the next is the sort of thing one imagines happening in the days of the Iron Curtain, or in a failed South American state. But capricious and arbitrary rule by whim is alive and well in the shadowy and underexposed Central Asian republic of Turkmenistan.

Last week Turkmen Trade Minister Amandurdy Ishanov was led off in handcuffs to one of the regime’s notoriously abusive prisons alongside numerous other condemned men after publicly “confessing” to a corruption charge launched by the country’s unpredictable ruler, Gurbanguly Berdymukhammedov. The dubious admission before a Turkmen court took place with all the theatrics of a show trial, with anonymous witnesses claiming that the authorities were motivated by the desire to look proactive in tackling corruption. Doubtless some personal scores within the regime were being settled, too.

Turkmenistan’s president, who took over from independence-era dictator Sapurmarat “Turkmenbashi” Niyazov in 2006, is known for his surreal public stunts. These performances would be amusing were they not the actions of a very real modern dictator, and include lifting a barbell before applauding ministers for broadcast on state media, starring in a video in which he fires rifles and throws knives while donning action-hero combats, and appearing with obviously-dubbed vocals in a musical Christmas holiday special. Given this is a man who also spends his impoverished citizens’ money on gilded equestrian statues of himself, one is not filled with confidence as to his propensity for judicial objectivity.

If Ishanov is in fact guilty, his crimes represent a drop in the ocean for this backward and corrupt state.  A recent report by the respected UK think tank The Foreign Policy Centre describes corruption as “an endemic feature of Turkmenistan’s economic life”, with Transparency International ranking it 161st out of 180 countries surveyed. Berdymukhammedov’s relatives reportedly benefit from the state’s coffers, with public funds being funnelled through state-affiliated companies run by the president’s family members as a matter of routine.

When the denounced Ishanov commences his time as a guest of the government he will face a bleak future. Not only has he been jailed for an indeterminate and undisclosed period, he will also likely face torture and unsanitary conditions. Turkmenistan has an appalling human rights record, with the Bertelsmann Transformation Index rating it 119th out of 129, and a ranking of 204th of 2010 in the Freedom House Freedom in the World Index. The Foreign and Commonwealth Office lists Turkmenistan as a Human Rights Priority Country, and the regime has been criticised by the Organisation for Security and Co-operation in Europe for lacking any of the prerequisites of a democratic process.

Critics of the government can find themselves imprisoned without proper trial for indefinite periods, with relatives kept entirely in the dark as to their loves ones’ fate. Some dissidents simply disappear altogether, in the manner in which anyone daring to criticize the Soviet regime could find themselves “unpersoned” in the 20th century. Inmates have no access to legal representation, external medical professionals or to contact with international monitoring organisations. The 'Prove They Are Alive Campaign' has also documented prison beatings and other inhumane practices within the system.

The sudden sacking of a trade minister feels like the action of a desperate regime. The government is clutching at straws to find some breakthrough for the flagging economy as it seeks foreign investment. Its systematic failure to do so, and Berdymukhammedov’s repeated failure to accept responsibility, combine to give the strong impression that Ishanov may have been an all too convenient scapegoat.

Without serious domestic reform it is unlikely that Turkmenistan’s image as an investment prospect is ever likely to improve. Its investment landscape is fraught with inherent risk, both financial and reputational. Procurement is conducted on the basis of personal and political connections with regime officials, and poor public finances and lack of currency have repeatedly led to non-payment of contracts. There is not only a lack of liquidity; there is outright government impecuniosity.

There is serial abuse of investor rights; the Cakiroglu Group suspended operations in Turkmenistan in 2018 after being owed several million dollars by the government and agricultural producers have seen their assets seized as soon as they become profitable. Russian-based telecoms company MTS witnessed its licence to use state telecoms infrastructure arbitrarily and suddenly terminated in an act that saw a monopoly restored to the state operator and losses to MTS running into the millions. Neither are Turkmen companies are not trusted abroad – the European Aviation Safety Agency banned Turkmenistan Airlines from flying within EU airspace for safety reasons.

Private sector businesses operating inside Turkmenistan risk exposure to supply chains that may include forced labour; especially during the cotton harvest thousands are forced from their homes and their regular jobs to pick cotton in Turkmenistan’s vast fields. Driven and unpaid labour includes the use of children.

While Turkmenistan’s need for economic restructuring goes unattended and its people languish in poverty, the persecution of political dissidents and the abuse of prisoners continues. Two weeks ago the deaths of two graduates in prison was documented; they had been jailed for their support of Turkish cleric Fethullah Gulen, and another Gulen supporter, Alisher Mukametgulyev, is continually denied urgent medical assistance while he is detained in the Ovadan-Depe jail. The regime also practices the imprisonment of conscientious objectors.

As the economic crisis deepens, Berdymukhammedov is sure to look around for yet more officials to blame. In statist command economies such as Turkmenistan individuals seek officialdom for the protection and advantages it brings, but in this unreformed post-Soviet country it appears that no-one – except the president himself – is truly safe.

coronavirus

Update: Co-operation under the microscope in COVID-19 crisis – EAPM EU Presidency Conference report available

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As coronavirus infections soar across the planet, and the death toll rises everywhere, not least in Europe, many are asking why European Union member states were so disconnected from each other strategy-wise, and what the EU can do about improving co-ordination this second time round, writes European Alliance for Personalised Medicine (EAPM) Executive Director Denis Horgan. 

Well, given that health care is a jealously guarded member state competence, locking-down the answer isn’t easy, and never has been. But that doesn’t help Europe’s citizenry, given that COVID-19 is no respecter of borders and national sovereignty. 

This was one of a myriad discussion items discussed in our recent virtual Presidency Conference entitled ‘Ensuring access to innovation and data-rich biomarker space to speed better quality of care for citizens’. You can read the report here.

As highlighted during the Presidency Conference, there is potential future promise in the European policy context, with the legislative and policy initiatives currently on the EU agenda – most recently – the declaration of Commission President Ursula von der Leyen in favour of European Health Union which was discussed during the conference. 

EAPM has always argued for more EU-wide co-operation and coordination in health care, and the current crisis has only made that need more obvious. 

Indeed, for the best part of a decade,  the Alliance has been calling for policies to tackle diseases of many different types - not least cancer - through new science and personalised healthcare, with the backing of many MEPs.

It is apt that throughout the topic-specific discussions of the Presidency Conference, the broader themes that emerged most insistently were collaboration and communication, since these have been the hallmarks of EAPM’s activity since its initiation. 

EAPM is by definition a collaborative exercise, bringing together the broadest range of stakeholders – as this conference again demonstrated. And communication has been at the heart of EAPM’s activity, since its role is not just as a thinktank for refining ideas, but as a vehicle for transmitting those ideas from the world of healthcare to the broader world of policy, where the decisions are made that ultimately shape the way health is delivered. 

Principal recommendations 

Although there was no formal process of agreeing recommendations at the meeting, the following are among the recurring recommendations from the discussions. 

  • Inequalities in access to testing and treatment across Europe must be addressed

  • Adequate data infrastructure and processing capacity must be available.

  • Real-world evidence must be developed and acceptance criteria agreed with regulators, HTA agencies and payers.

  • Greater flexibility in regulatory requirements is needed to accommodate evaluation of products destined for small populations.

  • Multi-stakeholder collaboration must be developed to agree research priorities, standards and quality assurance of testing, and evaluation criteria for testing and treatments.

  • Trust must be developed among citizens about the security and possible  use of their data.

  • Communication must be developed by healthcare stakeholders to persuade policymakers to effect constructive change.  

The link to the report is available here.

1 million genome meeting on 21 October

Registration is still very much open for the B1MG meeting on 21 October. The aim of the the 1 million Genome Project is to support the connection of national genomics and data infrastructures, co-ordinate the harmonization of the ethical and legal framework for sharing data of high privacy sensitivity, and give practical guidance for the pan-European coordination of implementing genomic technologies in national and European health-care systems. 

Thus, the B1MG is a means to bring the different stakeholders together on Oct 21st so as to act as a catalyst to provide a benchmark approach for alignment of complex, fractionated health-care provisions into health-care systems.

Register here and read the full agenda here.

Have the best week possible, and keep safe.

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Brexit

We’re disappointed by EU but a deal can be done, says Raab

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Britain is disappointed by the European Union’s demand that London give more concessions to secure a trade deal but a deal is close and can be done, British Foreign Secretary Dominic Raab said on Friday (16 October), write Guy Faulconbridge and Paul Sandle.

“We are disappointed and surprised by the outcome of the European Council,” Raab told Sky News.

“We’ve been told that it must be the UK that makes all of the compromises in the days ahead, that can’t be right in a negotiation, so we’re surprised by that but the prime minister will be saying more on this later today.”

“Having said that, we are close,” Raab said of a deal. “With goodwill on both sides we can get there.”

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coronavirus

France reports more than 25,000 new coronavirus infections in past 24 hours

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A doctor, wearing a protective mask and a protective suit, works in the Intensive Care Unit (ICU) where patients suffering from the coronavirus disease (COVID-19) are treated at the Bethune-Beuvry hospital in Beuvry, France. REUTERS/Pascal Rossignol

The French health ministry reported 25,086 new confirmed coronavirus cases in 24 hours on Friday (16 October), after reporting a record 30,621 on Thursday (15 October), writes Geert De Clercq in Paris.

It also reported that 122 people had died from coronavirus infection in hospitals in the past 24 hours, compared with 88 on Thursday. Including deaths in retirement homes - which are often reported in multi-day batches - the death toll increased by 178 on Friday.

The total number of infections since the start of the year now stands at 834,770, the cumulative number of dead at 33,303.

The number of people in hospital with COVID-19 rose by 437 to 10,042, exceeding 10,000 for the first time since mid-June, and the number of people in intensive care rose by 50 to 1,800, a level last seen in mid-May.

In the past seven days, France has registered nearly 14,800 new coronavirus infections, which is more than the 132,430 registered during the entire two-month lockdown from mid-March to mid-May.

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