U.S. Department of State

The graph shows Turkmenistan's democratic reform scores in 2004* (the gray shaded area) as compared to its democratic reform scores in 1999. Since 1999, the democratic reform sector has remained unchanged.

*Actual 2005 scores not yet available.

Economic Reform in Turkmenistan

The "radar" or "spider web" graphs below illustrate Turkmenistan's economic performance during 2004. Ratings are based on a 1 to 5 scale, with 5 representing the greatest advancement. These charts provide a disaggregated look at each of the indices and are reported to Congress on a regular basis. The gray shaded area represents 2004 performance levels, while the two dark line indicates how each country compares in its progress vis-�-vis two standards: (1) the average of Romania's and Bulgaria's performance in each indicator as of 2002 (2002 was the year that Romania and Bulgaria - the "threshold countries" - were invited to join NATO and received favorable indications of future EU membership); and (2) where the country stood in each indicator in 1999. Together, these charts provide a broad picture of where remaining gaps are in a country's performance, and to what extent these gaps are being filled. For more information, including a detailed explanation of each indicator shown in the graph, see USAID/E&E/PO, "Monitoring Country Progress in Central and Eastern Europe & Eurasia," No. 9 (April 2005). Found online:: www.usaid.gov/locations/europe_eurasia/country progress/.

The graph shows Turkmenistan's economic reform scores in 2004* (the gray shaded area) as compared to the average of Romania's and Bulgaria's economic reform scores in 2002 (the bold line) when they were invited to join NATO and received favorable indications of future EU membership.

*Actual 2005 scores not yet available.

The graph shows Turkmenistan's economic reform scores in 2004* (the gray shaded area) as compared to its economic reform scores in 1999. For example, since 1999, Turkmenistan's economic sector indicates progress in all areas except private sector share.

*Actual 2005 scores not yet available.

FY 2005 Country Program Performance

Democratic Reform

The GOTX introduced few tangible improvements in democratic reform this past year. Following events in other Central Asian countries, the Government tightened its control of many aspects of civil society. As a whole, the Government moved further away from democratic reform. The GOTX continued to consolidate power centrally and to control the lives of Turkmenistan's citizens through both formal and informal policies. Civil society groups still faced difficult registration rules, but two non-governmental public associations succeeded in becoming registered in the past year, bringing the total to five. Even though non-governmental organizations (NGOs) have successfully advocated for small-scale changes at the local level, civic action remains risky. Registered NGOs are aggressively monitored by local security operatives. This actually has the unintended positive result of the security bodies witnessing the important work NGOs are undertaking in their communities. Regrettably, however, this firm control keeps civil society advocates in check. A weak judiciary follows the will of the president and is unprepared to protect civil, criminal, commercial, and other legal rights. The government controls all domestic media, and citizens' only access to outside information comes via satellite dishes that adorn the outside of almost every apartment and house. Reporters Without Borders just released its 2004 rankings for Access to Information; Turkmenistan ranked 177 of 179 countries rated, ahead of only Eritrea and North Korea. The GOTX continued to control and monitor the population's limited access to the Internet. Freedom House's 2005 Nations in Transit ratings again placed Turkmenistan at the bottom on every dimension (the worst in Central Asia): electoral process (7); civil society (7); independent media (7); governance (7); and constitutional, legislative, and judicial framework (7).

Any previous indications of political instability following the 2002 coup attempt have all but disappeared. The external opposition remains fragmented and lack domestic support due to its own perceived corruption. Although individual displeasure with the regime exists, due to the declining quality of education and the healthcare system, the people of Turkmenistan appear reluctant to challenge the status quo, which would potentially jeopardize the enormous state subsidies they currently receive. Certain social indicators such as unemployment and narcotics usage bode ill for the future. Religious oppression improved incrementally from last year. The signs of the emergence of an officially endorsed extreme form of nationalism, with an accompanying lack of respect for minorities, are worrisome.

U.S. ASSISTANCE PRIORITIES

USG assistance invests in building the capacity and skills for the next generation of leaders. While the repressive regime continues, our beneficiaries are playing an important role in keeping civil society functioning with a positive vision for the future. This interaction often comes with a price, since the GOTX makes the lives of civil society actors more difficult. However, the people with whom the USG works want a better, more prosperous and, most importantly, democratic Turkmenistan, and accept the risks that come with USG assistance. Although meaningful democratic reform in Turkmenistan does not appear imminent, the USG's human capital development focus positions the USG to respond to unexpected changes in the political landscape and provides linkage between the people of Turkmenistan and the modern world. Furthermore, in this environment, it is critical that we actively seek out future leaders, and provide them with educational and professional exchange opportunities as well as access to information from the outside world.

PROGRAM PERFORMANCE

FY 2005 has been no exception from the past in the development of democracy in Turkmenistan. The Government of Turkmenistan renewed a purge of potential rivals to President Niyazov, significantly closing the political space in Turkmenistan. The USG provided critical assistance to many NGOs and communities that might not otherwise have been able to survive. Additionally, the USG mobilized legal teams across the nation to provide technical support to NGOs trying to register to operate in Turkmenistan. Although only two NGOs were registered last year, others responded to technical questions posed by the Ministry of Justice with the help of USG-funded resource centers. Because the registration process is slow and many NGOs are discouraged from trying to obtain registration, the USG refocused its efforts to mobilize communities to solve local problems in partnership with local governments. This support to indigenous civil society movements is the foundation of the USG Democracy strategy, and will build trust at the local government level. The USG continued to fund a legal resource center at Turkmen State University, which provided valuable legal resources to over 8,000 students, lawyers, and legal professors over the past year. The USG focused on opening legal clinics to provide practical experience to young lawyers and to provide pro-bono legal services to Turkmen citizens in the areas of family law, property law, and other civil law matters.

Peace Corps programming is an integral part of the USG's democratization activities. USG assistance for Peace Corps supports the work of 61 volunteers working in the fields of education and health. Peace Corps' Volunteers (PCV) not only teach skills and ideas promoting U.S. values, but also provide a valuable link between the people of the United States and Turkmenistan. PCVs work as English teachers, lead community projects, and establish programs for Turkmen youth. While the Peace Corps' program in Turkmenistan is nominally supported by the government, day to day operations receive little tangible evidence of this support, so the Peace Corps program has turned to international agencies and the few independent organizations that operate in the country for opportunities for project opportunities. Successful examples of such collaborative efforts include working with USG-funded implementers to deliver health-related training seminars and develop materials and support implementation of the TB-DOTS program in Ashgabat. In the future, Peace Corps plans to extend and strengthen these relationships. PCVs also assisted in over 35 summer camps for youth in 2005 that focused on a variety of topics, including sports, art, language, teacher training, and Model UN activities. In collaboration with their host country colleagues, PCVs provided the opportunity for nearly 2,000 young people and teachers to participate in these camps.

The USG continued a robust educational exchange program from high school through post-graduate school level. However, the total number of exchange participants in FY 2005 was reduced by seven percent due to the elimination of two exchange programs. The USG did support four-year scholarships for 17 Turkmen students (13 new in 2005) to study at the American University of Central Asia, in Bishkek, in a bid to counteract the extreme degradation taking place in Turkmen institutes of higher education.

The USG funded 2 additional Internet centers and a fourth American Corner that has attracted over 17,000 visitors since it opened in late 2004. PCVs are also active at the American Corners around the country. Currently, there are four PCVs assigned to the centers who are working with local students and other visitors on a daily basis. Volunteers also work in the American Corners on projects, training, language activities and other issues important to their development.

In FY 2004, $167,767 out of a total of $200,000 in Democracy Commission funds were allocated in FY 2004, causing Turkmenistan's Democracy Commission allotment to be reduced for FY 2005. The USG's inability to obligate funds in FY 2004 resulted from Turkmenistan's enactment of a draconian NGO registration in late 2003 whose effect only began to fade in June 2004 when the first grants were signed for FY 2004 funds. In 2005, the USG was able to make full use of its Democracy Commission funding of $160,000 by distributing 39 Democracy Commission to civil society organizations working on a range of social issues. Funded projects included the creation of Internet-enabled educational resource centers to promote Internet access and free flow of information, as well as American studies and English language, particularly to disadvantaged youth. Short-term projects to catalyze civil society development included roundtables, conferences and summer camps emphasizing youth leadership and professional development, and events to encourage dialogue between civil society groups and the GOTX by including government representatives in discussions of NGO registration, community environmental initiatives, and human rights. The OSCE contributed two speakers to this event in August 2005. In 2005, the Democracy Commission funded 13 successful youth leadership camps and professional development conferences and camps for English teachers, many of which received additional support from Peace Corps' Volunteers. Democracy Commission grants also continued to support provision of legal counseling to vulnerable and impoverished people, the rehabilitation of physically and mentally challenged individuals, small business development activities for disabled and socially vulnerable people, and community mobilization projects.

MEASURES OF PROGRAM EFFECTIVENESS

In order to determine how U.S. Government assistance affects a country, U.S. embassies set targets for improvement called "performance indicators." Data for these indicators are collected by research institutes, embassies and international organizations. By examining data over time, U.S. policymakers better understand whether specific assistance programs are making their intended impact and, if necessary, how to adjust these programs to improve the impact.

Please find below two important indicators in the area of Democratic Reform. In the charts, the "Baseline" refers to a starting point from which to measure progress or regression over time. The embassy and its partner organizations then agree on a "Target" figure that they hope to achieve as a result of U.S. assistance programs. The "Rank" figure is the resulting measurement. "CY" stands for "calendar year," or January 1 to December 31, while "FY" stands for "fiscal year," the period of the U.S. budget that runs from October 1 to September 30 of the following year.

Performance Indicator: Civil Society Index. Assesses the growth of nongovernmental organizations (NGOs), their organizational capacity and financial sustainability, and the legal and political environment in which they function; the development of free trade unions; and interest group participation in the policy process. Measured on a 7-point scale, where 1 indicates a very advanced NGO sector and 7 indicates a weak NGO sector. Source: Freedom House, Nations in Transit 2005. The data 2005 rank was based on 2004 data. Found online: www.freedomhouse.org/research/nattransit.htm.

According to Freedom House, the CY 2005 ranking did not change because of the continuing draconian restrictions on the activities of both NGOs and minority religious communities. While not captured in the Freedom House evaluation, over the past year, two more civil society organizations that were not affiliated with the GOTX were able to successfully register to operate legally in the country, bringing the total to seven non-government affiliated organizations that have been registered to date since passage of the new NGO law in 2003. While this was a small change, it is significant in that it demonstrated to other civil society organizations that registration is possible and it has encouraged them to persevere in their efforts. In addition, there were indications that the GOTX was increasingly open to dialogue with NGOs.

Performance Indicator: NGO Sustainability Index. Seven different dimensions of the NGO sector are analyzed each year in the NGO Sustainability Index: legal environment, organizational capacity, financial viability, advocacy, service provision, NGO infrastructure and public image. The NGO Sustainability Index uses a seven-point scale, to facilitate comparisons to the Freedom House indices, with 7 indicating a low or poor level of development and 1 indicating a very advanced NGO sector. The 2005 rank is based on 2004 data. Source: USAID. Found online: www.usaid.gov/locations/europe_eurasia/dem_gov/ ngoindex/2004.

While the overall ranking has improved since the FY 2004 rank, it did not improve enough to meet the expected target due to continued difficult operating environment for NGOs. While USG program implementers adapted their programmatic approaches and implementation strategies to the more difficult operating environment, the USG's programs met with only limited success. Over the past year, the USG worked with seven organizations at the community level, including schools, health clinics, community-based organizations, and farmers' associations. Given the difficulties of directly addressing civil society strengthening, USG programs have concentrated on community mobilization, the identification of communities' priorities, and funding small-scale projects. These projects have usually been infrastructure-related or meet other needs of the communities. The experience of working together to identify problems, prioritize community needs, and then manage implementation of a program has strengthened community ties and provided concrete examples of benefits of community participation and dialogue.

The GOTX offered its endorsement of and participation in at least two USG-organized conferences promoting event grassroots organizing and the role of civil society in development, one of which focused on ecological issues. These events prompted follow-up actions, including a human rights roundtable, among community activists.

Economic Reform

Private sector growth continues to lag, in spite of government figures touting 20 percent GDP growth during the first eight months of 2005. Over the year, little progress was made to stimulate change in the economy, but there was a visible reduction in the number children working in the cotton fields. Unemployment remains high, and has contributed to a significant increase in drug use among youth. Due to the lack of transparency and the government's unwillingness to share information, accurate numbers on Turkmenistan's per capita GDP and poverty are not available. The World Bank and International Monetary Fund estimate that 58 percent of the population lives below the poverty line and GDP per capita income is $649 (versus recent Government figures of $7,500 GDP per capita). Although small enterprises report that they are able to work with little impediment, other than the lack of currency conversion, they are unable to expand and offer greater employment opportunities. In contrast to official GOTX statistics, international organizations estimate unemployment at about 50 percent, especially among the growing young adult population.

U.S. ASSISTANCE PRIORITIES

The USG's economic reform programs focus on increasing transparency, educating entrepreneurs on enterprise development, and engaging the government on economic liberalization and financial sector reform. USG assistance programs seek out entrepreneurs who will increase productivity and sales by streamlining their functions and promoting better quality management. Since the USG's level of funding and opportunities for promoting economic growth are very limited, USG implementers concentrate on building a culture of entrepreneurship and training future business leaders to deal with marketplace obstacles. The USG inculcates financial transparency through its accountancy-training program and work with the Central Bank. The USG, through the Junior Achievement program, also supports training of young people in basic business skills and market economics at the high school level, providing a platform to launch future business professionals.

PROGRAM PERFORMANCE

The USG continued to find ways to contribute to the economic development of Turkmenistan, despite the poor operating environment for private sector activity. USG assistance was delivered principally through educational programs rather than official cooperation with government agencies. Our efforts to provide much needed business and accounting training achieved their persons trained targets, and produced signs that our assistance is having an impact. Graduates of USG-funded international accounting standards courses organized a professional association in FY 2004, which received an association development grant from a USG implementer in FY 2005. The association was registered by the Government of Turkmenistan, but for a variety of reasons has had little impact in advocating for the introduction of international accounting standards. The Enterprise Development Project (EDP) targeted entrepreneurs and small businesses in the main cities of Ashgabat and Mary and provided training to 834 participants, 64 percent of whom were women, for a total of 16,680 participant training hours. In addition to business short courses, EDP successfully began to extend direct firm-level assistance in the areas of strategic planning, marketing, and financial management, despite challenges in building trust with entrepreneurs.

At the high school level, Junior Achievement was approved by the Ministry of Education as an official elective course, which makes it the only available course on market economics available to Turkmenistan's students and creates an opportunity for further USG assistance with the Ministry of Education. Sixty schools throughout Turkmenistan now have Junior Achievement as part of the core curriculum or as an extra-curricular activity. Cooperation with the Central Bank of Turkmenistan has been postponed after the Chairwoman's dismissal in May; however, there are indications that renewed interest from the new administration may result in further accounting training with a cost-share element from the Central Bank. The Regional Trade Promotion (RTP) component of EDP has been an overwhelming success over the past year, even though significant cross-border legal and financial hurdles exist for businesses. Over the past three years, the volume of transactions within the framework of the RTP has increased from $62,000 in FY 2003 to $473,850 in FY 2004 to $1,050,647 in FY 2005. The RTP program trained a private trader during the past year, and after working with this local partner, over $700,000 in contracts were facilitated by the USG. Although trade capacity building is not a direct part of the USG's assistance program in Turkmenistan, the USG will continue to press the government to open up this area of private sector development.

The USG, through its Water User Association Support Program, has launched a number of activities that have helped farmers to improve their water management capacity, increased their agricultural productivity, and informed them about their legal rights. For example, the Agricultural Support Center, established in the Mary Region of southeastern Turkmenistan, has become the main training facility, resource library, computer center, agribusiness consultant, outreach agent, and donor liaison to farmers throughout the region. With the technical support and legal consultations provided by the support center, farmers successfully negotiated fair terms of cotton sales to the Governmental Agricultural Joint Stock Company that yielded about $70,000 in revenue for 30 farmers.

MEASURES OF PROGRAM EFFECTIVENESS

In order to determine how U.S. Government assistance affects a country, U.S. embassies set targets for improvement called "performance indicators." Data for these indicators are collected by research institutes, embassies and international organizations. By examining data over time, U.S. policymakers better understand whether specific assistance programs are making their intended impact and, if necessary, how to adjust these programs to improve the impact.

Please find below two important indicators in the area of Economic Reform. In the charts, the "Baseline" refers to a starting point from which to measure progress or regression over time. The embassy and its partner organizations then agree on a "Target" figure that they hope to achieve as a result of U.S. assistance programs. The "Rank" figure is the resulting measurement. "CY" stands for "calendar year," or January 1 to December 31, while "FY" stands for "fiscal year," the period of the U.S. budget that runs from October 1 to September 30 of the following year.

Performance Indicator: Private Sector Share of GDP (In percent). Source: European Bank for Reconstruction and Development Transition Report 2005. Found online: www.esdb.cdie.org/cgibin2/broker.exe?_program=programs.source_EBR_1.sas&_service=default&pick=1

USG economic development programs provide technical assistance and training to entrepreneurs, agricultural producers, and trade associations. In addition to offering targeted consulting services to improve the profitability of these entities' operations, the USG also supports seminars on international financial reporting standards for business managers, accountants, and entrepreneurs. A regional trade development activity promotes commercial linkages between Turkmen firms and other Central Asian businesses. Additionally, a new program in FY 2005 assists local farmer's organizations to improve water management and production efficiency. By providing market-based economics courses to future entrepreneurs, the USG aims to instill the future generations with the skills necessary to compete in a global economy.

FY 2005 saw no change in the private sector share of GDP. Approximately 75 percent of the official economy remains under state-control and the GOTX showed no indications of moving away from such policies. Related to this, Turkmenistan continues to rely on natural gas and oil sales to support its budget and attempts to diversify its economy have revolved around creating state-owned enterprises. In spite of certain measures that were intended to improve the environment for small and medium enterprises (SME), in reality, the ongoing lack of convertible currency, limited access to credit, and excessive public spending on projects that do not further private economic or social development, contributed to the lack of improvement in this sector. With the exception of the oil and gas sector, foreign investment in Turkmenistan remains limited.

Performance Indicator: Economic Reform Index (EBRD). Includes components on small-scale and large-scale privatization; trade liberalization; price liberalization; corporate governance; competition policy; banking; and non-banking financial reforms. Scores range from 1 to 4, with 4 being most advanced. The 2005 rank is based on 2004 data. Found online at: www.esdb.cdie.org/cgibin2/broker.exe?_program=programs.source_EBR_1.sas&_service=default&pick=1

The GOTX has expressed limited desire for technical assistance on economic reforms. Cooperation with the Central Bank of Turkmenistan (CBT), which was limited in FY 2005, primarily focused on introducing banking supervision practices. A change in management has not yet produced new breakthroughs, but there appears to be a desire among the Central Bank management to understand modern banking practices and to adopt international accounting practices. Approximately 75 percent of the official economy remains under state-control, and the GOTX showed no indications of moving away from such policies. In spite of certain measures undertaken that were intended to improve the environment for SME, continued reliance on state-owned enterprises, import substitution, and a lack of convertible currency prevented improvements in this sector.

Social Reform and Humanitarian Assistance

The GOTX demonstrated interest in 2005 to implement badly needed reforms in the health sector and asked the USG to assist in the design of a new health insurance system. The GOTX also approved the World Health Organization (WHO)-recommended Directly Observed Treatment Short-course (DOTS) strategy for TB and an HIV/AIDS prevention strategy. According to the 2000 Turkmenistan Demographic and Health Survey, Turkmenistan has the second highest infant mortality rate in Central Asia after Tajikistan, with 74 deaths per every 1,000 live births and an under-five mortality of 94.3 out of 1,000. The same survey found that 47 percent of women and 36 percent of children are anemic. According to a joint report prepared by the U.N. Children's Fund (UNICEF) and the U.S. Centers for Disease Control and Prevention (CDC) related to the "Main Reasons for Child Morbidity and Mortality in Mary Welayat of Turkmenistan," 7.51 percent of children die during the first year of life, mostly from preventable illnesses. This indicates that many deaths occur because of medical incompetence and poor healthcare provided to children. Changes in mandatory schooling from ten to nine years in 2001 has left parents concerned about what the future holds for their children.

Despite modest progress, in the 2005 publication "Human Rights and Health in Turkmenistan," Bernd Rechel and Martin McKee sharply criticized the current health care system, stressing the falsification of epidemiological data and poor conditions. Another concern was the reorganization of regional hospitals and clinics. Many experts concluded that the program could be considered a rational part of an overall restructuring if the money saved from closing some sites was reinvested into the system, but there is no indication that the money saved was invested to improve health care. The GOTX reacted to criticisms by organizing an exhibition highlighting health care achievements over the last decade and celebrating the 10-year anniversary of the State Health Program in December 2005. During the anniversary event, the GOTX opened a new building for the Ministry of Health, a mother and child health hospital, and diagnostic centers in all regions of the country. This indicates a desire on the part of the government to address key visible weaknesses of the existing health care system. In some cases, symbolic steps, such as constructing expensive facilities, were taken, but training was often limited and conscripts continued to report to work in place of professional health care providers in many facilities. Nevertheless, the GOTX continues to be reluctant in interacting with international organizations that could assist it to better use its limited resources in this sector.

U.S. ASSISTANCE PRIORITIES

The USG's social sector programs focus on pressing the GOTX to accept recommendations for health care reform by focusing on the delivery of quality primary health care, promoting healthy lifestyles, fighting infectious diseases, and improving the lives of mothers and children. By establishing a trusting relationship with the Ministry of Health, the USG manages to engage the GOTX in critical reforms in areas that are not currently being addressed by social policy. The USG seeks to bring the GOTX into closer alignment with international standards of healthcare practice and to promote open and transparent methods for surveillance and prevention of diseases and illnesses.

PROGRAM PERFORMANCE

Health reform remains the area in which the USG has been able to make the most progress in Turkmenistan, with the exception of security cooperation. The "Keeping Children Healthy" campaigns expanded in FY 2005 to ten pilot centers, providing important information at the village level on acute respiratory infections, nutrition, and diarrhea. Through the American International Health Alliance, the Primary Care Training Center in Ashgabat continued to flourish, reaching 100 percent of all family nurses and doctors in Ashgabat with training on basic diagnosis and healthy lifestyles promotion. The opening of a second center for doctors and nurses from outside of Ashgabat was delayed until FY 2006. Having established a strong relationship with the Ministry of Health, the USG will start a second phase in primary care reform, offering training to doctor/nurse teams to improve their ability to identify and treat HIV/AIDS, other sexually transmitted infections, and domestic violence and providing guidance in developing open and congenial patient/doctor interaction. In addition, a training center for health care facility managers at the State Medical Institute will be launched this year. The center will train managers to make health institutions self-sustainable.

Under continuous pressure from the USG and other international donors, Turkmenistan finally agreed to support two programs aimed at reducing high child mortality rates, namely the Safe Motherhood Program and the introduction of an international definition for live childbirth.

Training in the DOTS methodology continued for TB specialists, primary health care physicians, and other health professionals in Ashgabat, Turkmenbashy, and Mary, with more than 500 professionals targeted in all regions. Work also continued toward the implementation of a TB DOTS pilot center in Balkanabat, which officially opened in December 2005. The TB situation in Turkmenistan remains serious. In 2004, the rate of reported cases was 67.5 per 100,000 people, and the mortality rate was 10 per 100,000. Even these figures underestimate the true magnitude of TB infection, as government statistics are unreliable. Since the introduction of the TB DOTS program in 2000, the number of pilots increased to six and covers about 40 percent of the population. Treatment success rates in DOTS pilots have risen from 66.5 percent in 2001 to 80 percent in 2003. In 2004, Turkmenistan successfully applied for TB drug support from the Global Drug Facility for three years.

The rate of HIV prevalence in Turkmenistan remains unknown, but the government has indicated interest in applying to the Global Fund for AIDS, Tuberculosis, and Malaria. The USG provided technical assistance during the preparation of the TB application; but, regrettably, the GOTX failed to submit applications for any of the three sectors. The USG launched a Blood Safety Program in Turkmenistan and equipped six laboratories for national blood banks. This program will prevent donors' blood from transmitting blood-borne infectious diseases, the most dangerous of which are HIV/AIDS and Hepatitis C.

With the support of international donors, including the USG, Turkmenistan drafted a National Safe Motherhood Strategy and a national plan for the ntroduction of an international definition for live childbirth, indications of its slow steps towards establishing health standards that meet international norms. The Integrated Management of Childhood Illnesses Program continues its expansion and now includes an additional five pilots.

Peace Corps' Volunteers (PCV) work in a variety of sites assisting with the health care, training, and awareness of health issues in the country. Working in clinics and hospitals, PCVs have assisted health care professional and the local population gain knowledge about various communicable diseases, including HIV/AIDS and Tuberculosis. A significant part of their work involves educating pregnant women and children about issues that are relevant to their health.

In the fall of 2004, Turkmenistan was the first Central Asian Republic to be recognized by WHO as having universal salt iodination. During FY 2005, the USG helped monitor the adequate iodine levels in all types of salt production available in the country. Turkmenistan continues to be free of polio and in 2005 confirmed 99 percent vaccination coverage. Through USG consultation and training, all newborns continue to receive Hepatitis B vaccinations, provided by the Global Alliance for Vaccination, to reduce the levels of viral hepatitis infection. This year, paid services for vaccination against Hepatitis B were opened in Ashgabat for adults and children who volunteer to be vaccinated. The USG actively participates in an inter-agency committee under the Ministry of Health to address these and other issues related to Hepatitis B.

MEASURES OF PROGRAM EFFECTIVENESS

In order to determine how U.S. Government assistance affects a country, U.S. embassies set targets for improvement called "performance indicators." Data for these indicators are collected by research institutes, embassies and international organizations. By examining data over time, U.S. policymakers better understand whether specific assistance programs are making their intended impact and, if necessary, how to adjust these programs to improve the impact.

Please find below an important indicator in the area of Social Reform and Humanitarian Assistance. In the chart, the "Baseline" refers to a starting point from which to measure progress or regression over time. The embassy and its partner organizations then agree on a "Target" figure that they hope to achieve as a result of U.S. assistance programs. The "Rank" figure is the resulting measurement. "CY" stands for "calendar year," or January 1 to December 31, while "FY" stands for "fiscal year," the period of the U.S. budget that runs from October 1 to September 30 of the following year.

Performance Indicator: Infant Mortality. Number of deaths of children under one year of age per 1,000 live births. Source: United Nations Statistics Division Millennium Development Indicators. Found on line: www.millenniumindicators.un.org/unsd.

Infant mortality rates for Turkmenistan reported by the United Nations Statistics Division and other international sources are much higher than those reported by the Turkmenistan Ministry of Health, due to the fact that the GOTX has used the Soviet definition of infant mortality, which considers pregnancies of less than 28 weeks or resulting in the birth of a baby weighing less than 1000 grams as late miscarriages. Unfortunately, this definition of live birth has resulted in infants not receiving basic lifesaving care at birth, and therefore has increased infant mortality in Turkmenistan. International organizations have historically estimated infant mortality through information collected by random sample surveys.

In response to technical assistance and policy support from the USG, the Ministry of Health agreed to implement the internationally-accepted World Health Organization (WHO) definition criteria for live and still births (frequently referred to as international live birth definition, or ILBD) nationwide in 2006. This is a critical first step in improving the chances for infants' survival. Turkmenistan currently has the second highest infant mortality rate in Central Asia, reported by UNICEF at 79 per 1,000 live births in 2003. The USG funded a one-week course on this topic in Ashgabat in June 2005. The USG and UNICEF will continue to support the MOH to prepare a legal and regulatory base for the adoption of ILBD and provide additional training courses.

The USG's work to improve the quality of health care for children and to ensure safe motherhood also impacts infant mortality. This year witnessed significant achievements in the area of child health. Building on USG technical inputs and models, the Government of Turkmenistan drafted a Safe Motherhood program, including a critical expansion of its program on the integrated management of childhood illnesses (IMCI). The USG expanded ongoing IMCI activities to pre-service medical and nursing training in close concert with the Ashgabat Mother and Child Health Institute, which resulted in a doubling of IMCI pilot sites nationwide. To date, about 700 patients and family members (out of an overall population of 600,000 in the pilot site areas) have benefited from these life-saving interventions. The USG sponsored a "Keeping Children Healthy" campaign on nutrition in Balkan region, in which family nurses provided informational materials on proper nutrition, anemia, and exclusive breastfeeding to 15,000 women. USG partners successfully trained every family physician in each of the original six pilot districts in IMCI. IMCI was introduced to the pre-service curricula of the Turkmen State Medical Institute and of the medical schools in each of the country's five regions. During this process, the USG funded training for 38 faculty members at the State Medical Institute and introduced IMCI to 20 family nurses in each of the five regions. The USG's maternal and child health program trained 200 family nurses on healthy pregnancy during the year.

Security, Regional Stability and Law Enforcement

The GOTX maintains internal security by using its resources to monitor and quell any internal dissent. It does not cooperate with nearby nations to provide a solid regional security organization. The Ministry of Internal Affairs maintains a solid force of cadre capable of enforcing the laws, but is riddled with corrupt officials. The Ministry of Defense is tasked with maintaining the traffic laws and is also tasked with providing cheap labor for construction sites, cotton-picking and for certain other industries.

There are no bilateral information exchange agreements with the United States or other countries. The GOTX does not appear to be ready to carry out basic reforms in its security apparatus. Even so, the United States continues to engage in numerous areas so as to inculcate future generations with key aspects of U.S. interests and values.

U.S. ASSISTANCE PRIORITIES

In FY 2005, USG security-related assistance in Turkmenistan was geared toward preventing trafficking in narcotics and the proliferation of weapons of mass destruction (WMD) through training programs and donation of equipment such as tools, search equipment, and vehicles. The U.S. provided equipment and training to increase forensic capabilities, improve border checkpoints, and to help combat trafficking in persons. In addition to providing Foreign Military Financing (FMF) to counter the threat posed by narcotics trafficking and WMD, the USG sent members of Turkmenistan's military on U.S.-based training under the International Military Education Training (IMET) Program and to security and counterterrorism related courses at the George C. Marshall European Center for Security Studies. Over the past year, there was a notable increase in cooperation between the Government of Turkmenistan and bi-lateral and international partners working in this sector.

PROGRAM PERFORMANCE

Despite profound differences with the GOTX, the USG has been able to maintain and expand certain regional security assistance programs that are important to U.S. homeland security, anti-terrorism, and anti-narcotics efforts. Turkmenistan's military lacks basic skills and equipment. In FY 2005, the U.S. Department of Defense had modest success in conducting IMET programs for a total of seven participants from Turkmenistan. Turkmenistan also received FMF in FY 2005, which the government is using to purchase a system of Motorola radios for Turkmenistan's emergency response communication system and an upgrade package of tactical radios. In addition to these regular programs, a Border Security Initiative provided Department of Defense counter-narcotics funding to build two border facilities for the Government of Turkmenistan on the borders with Afghanistan and Iran.

The USG-funded Export Control and Related Border Security (EXBS) Assistance Program overcame the GOTX's reluctance to participate in regional security programs and allowed regular visits to commercial border crossings to evaluate the needs of the customs and border services. EXBS projects provided additional water trucks, jeeps, a Motorola communications suite for the Border Guards, a U.S. Coast Guard Boarding Officer Course and Port Security Training at the port of Turkmenbashy. During FY 2006, GOTX officials will attend an International Seaport Security Training in Charleston, South Carolina, an International Border Interdiction Training in McAllen, Texas and an International Airport Interdiction Training at JFK Airport in New York.

MEASURES OF PROGRAM EFFECTIVENESS

In order to determine how U.S. Government assistance affects a country, U.S. embassies set targets for improvement called "performance indicators." Data for these indicators are collected by research institutes, embassies and international organizations. By examining data over time, U.S. policymakers better understand whether specific assistance programs are making their intended impact and, if necessary, how to adjust these programs to improve the impact.

Please find below two important indicators in the area of Security, Regional Stability and Law Enforcement. In the charts, the "Baseline" refers to a starting point from which to measure progress or regression over time. The embassy and its partner organizations then agree on a "Target" figure that they hope to achieve as a result of U.S. assistance programs. The "Rank" figure is the resulting measurement. "CY" stands for "calendar year," or January 1 to December 31, while "FY" stands for "fiscal year," the period of the U.S. budget that runs from October 1 to September 30 of the following year.

Performance Indicator: Rule of Law - Constitutional, Legislative, and Judicial Framework Rating. This indicator was drawn from Freedom House, Nations in Transit 2005 as modified by "Monitoring Country Progress (MCP) in Eastern Europe and Eurasia" USAID/E&E/PO, #9 April 2005. (1 = lowest, 5 = highest). The Rule of Law rating highlights constitutional reform, human rights protections, criminal code reform, judicial independence, the status of ethnic minority rights, guarantees of equality before the law, treatment of suspects and prisoners, and compliance with judicial decisions. The 2005 rank is based on 2004 data. Found online: www.usaid.gov/locations/europe_eurasia/country_progress/index.html.

Turkmenistan's score on this indicator is the lowest of all the Central Asian Republics. The score remains unchanged since CY 2004 and Turkmenistan did not meet the target that was set for 2005.

Performance Indicator: Corruption Index. Measures how experts view the state of corruption in a country. The score relates to perceptions of the degree of corruption as seen by business people and country analysts and ranges between 1 (highly clean) and 7 (highly corrupt). The 2005 rank is based on 2004 data. Source: Freedom House Nations in Transit 2005. Found on line: www.freedomhouse.org/research/nattransit.htm.

Corruption remains a pervasive issue in Turkmenistan. Although well publicized purges of government officials continued in 2005, many of which were allegedly for corruption, in practice this has not resulted in a better environment for businesses or individuals.

Click for FY 2005 Funds Budgeted for U.S. Government Assistance to Turkmenistan [PDF format]