As the old saying goes, there are only two certainties in life: death and taxes. The people of Uzbekistan can add a third item to that list: the re-election of President Islam Karimov. The 30 million people of this Central Asian nation have been living under Karimov’s rule for a quarter century and will continue to do so once Karimov undoubtedly wins a fourth term on March 29.

In the last twenty-five years, with Karimov’s guidance, Uzbekistan has become one of the world’s worst human rights violators. Freedom House has consistently described Uzbekistan as “Not Free” and this year gave it a rating of “Worst of the Worst”, a group that includes North Korea, Syria, Saudi Arabia, Sudan, and Somalia. Reporters Without Borders has ranked Uzbekistan 166th out of 180 in press freedom, worse than Burma, the Democratic Republic of the Congo, and Belarus. Restrictions on freedom of speech and association are just two items on a laundry list of human rights violations that includes much worse: religious persecution, torture, forced sterilization, and of course, arbitrary detention.

The exact number of political prisoners in Uzbekistan is not known, but it is estimated in the thousands. An accurate number is impossible to obtain since Uzbekistan is essentially a closed society. Following the Andijan massacre in 2005, the government forced many U.S.-based human rights observers out of the country, including Human Rights Watch, the American Bar Association, and Freedom House. Local human rights activists and independent journalists have either been imprisoned or threatened with violence. The Karimov regime has also been known to hide prisoners from the outside world by forcibly committing activists to psychiatric facilities and presenting imposters to humanitarian organizations.

One prisoner we know well is Bobomurod Razzakov, a prominent human rights activist and the chair of the Bukhara branch of Ezgulik, Uzbekistan’s only officially registered human rights organization. Razzakov’s activism focused on corruption, forced and child labor, and the rights of local farmers. He also occasionally acted as a source for Radio Free Europe/Radio Liberty and BBC Uzbek Services.

In the spring of 2013, Razzakov began receiving threats from Uzbek officials about his human rights work. They told him he faced life in prison if his work continued. A few months later authorities arrested Razzakov for human trafficking after a local woman supposedly claimed he and another woman forced her into prostitution. Upon arrest, police searched Razzakov’s house and seized his computer and materials related to his human rights work

Razzakov’s trial was plagued with inconsistencies and procedural violations. Authorities denied public access to the proceedings, Uzbek law enforcement threatened Razzakov’s family on multiple occasions when they led protests of the trial, the key witnesses for the prosecution offered contradictory testimony, and the court did not provide the defense an opportunity to review or rebut key evidence (for example, the prosecution withheld a medical report that allegedly showed Razzakov abused the victim).

On September 24, 2013 Razzakov was found guilty and sentenced to four years in prison. Threats from Uzbek authorities did not cease after his imprisonment. Officials visited him in jail and threatened to retaliate against his family if his son did not stop cooperating with international human rights organizations.

In addition to issuing threats, authorities physically abused Razzakov. A beating by prison officials resulted in a broken jaw and severe head trauma. The head trauma was so serious that Razzakov suffers from short- and long-term memory loss. When his family was finally allowed to visit him, Razzakov did not recognize his son or wife for some time. Razzakov also has serious medical conditions, including high blood pressure and ulcers, which have worsened since proper medical care has not been provided in prison. Prison doctors refuse to provide any documentation on Razzakov’s condition and his family is unsure if Razzakov is receiving the medicine they have been sending him.

On March 29, 2015 Razzakov will have spent 625 days in prison. This is a tiny fraction of the time Karimov has been in power, but for a man in poor health with his family in constant danger, it is an eternity. Razzakov is just a single voice among thousands who have been silenced by the Karimov regime. As Karimov is poised to embark on another eight years in power, the international community must speak loudly and with one voice to demand the release all prisoners of conscience in Uzbekistan.

For more information about Razzakov, please visit review our campaign page or read the petition recently submitted by Dechert, one of Freedom Now’s law firm partners, to the UN Working Group on Arbitrary Detention.