Prison officials sent Takhir Normukhamedov home to his family for his 41st birthday. His corpse, covered in torture marks, was delivered on a stretcher by ambulance.

His buttocks had been sliced away and burnt by electric shocks, his back was a mass of bruises from repeated beatings and his skull had been dented.

Mr Normukhamedov was the latest victim of what the United Nations calls “routine use of torture” in Uzbekistan under Islam Karimov. President Karimov has ruled Central Asia’s most populous state with an iron fist since 1989 and will win another seven-year term on Sunday in elections viewed by the West as a charade.

Mr Karimov, 69, should not even be a candidate, according to the Constitution, which limits presidents to two terms. He extended his first term by referendum until 2000 then won reelection with 91 per cent in a fraudulent ballot.

Another referendum extended his presidential term from five to seven years in 2002. Aziz Abidov, spokesman for the Central Election Commission in the capital, Tashkent, said: “This was the first term because we did not have a seven-year term before. If the head of state wins the election that will be his second term. Everything is done according to the law.”

Few dare to oppose such logic. Most opposition figures are in prison or exile and the only question on election day is the margin of Mr Karimov’s victory. He faces three candidates, described as “aunt sallies” by one local observer, to make it appear more democratic than in 2000, when even his sole opponent voted for him.

“Everything is done by order from above and people are just afraid. He will be elected because everything will be falsified,” said Surat Ikramov, who heads a small group of human rights activists.

Mr Ikramov, 63, is under constant surveillance by the secret police and was badly beaten up in 2003. His group has logged more than 12,000 cases of people imprisoned on political and religious grounds in the past decade.

The crackdown has intensified since troops killed hundreds of protesters in the city of Andijan in 2005. Mr Karimov insists that he is fighting terrorism by Islamic militants determined to overthrow the Government.

Criticism from Washington prompted him to shut down a US airbase set up to fight the war in Afghanistan. Mr Karimov also expelled foreign nongovernmental organisations and revived relations with Russia.

The European Union imposed an arms embargo and a visa ban on officials suspected of involvement in the Andijan massacre. It lifted the travel ban in October to encourage Uzbekistan “to take positive steps to improve the human rights situation”.

Mr Normukhamedov died on November 13. His sisters, Ranoh and Donoh, told The Times that he was an estate agent whose misfortune had been to visit a house under observation by the secret police.

He was accused of belonging to the banned Islamic group Hizb ut-Tahrir and jailed for eight years in 2002. His family said that he was a religious man but had no involvement with militants. “We know who tortured him but nothing has happened to them. When we went to the prison to ask why, they said it was because he was praying. Officially, we were told that he had a heart attack,” said Donoh.

Much of the pressure to ease sanctions came from Germany, which is keen to boost trade and which maintains a military base at Termes to supply Nato operations in nearby Afghanistan. One Western observer said: “The Uzbeks see the Germans as their friends in the EU but it still doesn’t get the Germans anywhere.”

Uzbekistan prospered on the ancient Silk Road between Europe and Asia that made its cities of Samarkand and Bukhara key trading centres. It remains rich in resources, particulary cotton, oil and gas.

Mr Karimov’s ruling clique keeps tight control of Uzbekistan’s wealth, while a third of its 27 million people lives in poverty and millions have emigrated. There is little sign of an election campaign in the gloomy capital, where buildings carry Soviet-style inscriptions of presidential phrases and Mr Karimov is pictured on billboards greeting his adoring people.

“I don’t see any hope for change. The regime is very strong,” said Umida Niazova, a journalist and human rights activist who was jailed for seven years in May, after materials about Andijan were found on her computer.

Ms Niazova, who has a two-year-old son, was released a week later amid an international outcry. She was barred from leaving Tashkent for seven years and must be home each night by 10pm.

Her concern is for 23 fellow activists still in prison. Of her own experience, she said: “A lot of my friends are abroad or in prison so maybe it was just my turn. I am afraid but I also have my dignity as a human being.”

Tough talker

— Islam Karimov, born in Samarkand in 1938, was raised in an orphanage before studying engineering and economics. He was First Secretary of the Uzbek Communist Party before the fall of the USSR

— In parliament in 1998 Mr Karimov said of Islamic extremists: “Such people must be shot in the forehead. If necessary, I'll shoot them myself.” Human rights groups believe many peaceful Muslims have also been imprisoned in security sweeps

— His response to terrorism has been criticised as heavy-handed. After violence in 1999 Mr Karimov said: “I'm prepared to rip off the heads of 200 people in order to save the republic”

— Mr Karimov responded to a critical report on the 1999 election by election monitors OSCE, saying: “The OSCE focuses only on establishment of democracy, the protection of human rights and the freedom of the press. I am now questioning these values”

— Under his rule Uzbekistan's economy has relied heavily on cotton. Sluggish growth during the 1990s has recently appeared to improve markedly — although the US believes the figures are doctored. Inflation rates of 20-40 per cent remain a huge problem and low unemployment figures hide high levels of underemployment

Sources: US State Department, CIA, Human Rights Watch

Times Recommends

• Tehran cannot live up to its rhetoric
• The new unicycle that will ‘change the world’
• We cannot wish away Iran’s bomb