And Mr Karimov has allegedly fallen out with his daughter Gulnara, who accuses him of having her beaten.
Mr Karimov came to power with a massive 86 per cent of the vote, a huge margin which might give you the indication the poll wasn’t exactly legitimate.
It is widely argued that Mr Karimov’s corrupt, dictatorial regime has since contributed heavily to making Uzbekistan one of the world’s 50 poorest nations.
The toll on Mr Karimov’s family has been just as tragic. The 76-year-old dictator is now completely alienated from his daughter Gulnara Karimova, who this week smuggled a desperate letter to the BBC outlining her plight.
“I am under severe psychological pressure, I have been beaten, you can count bruises on my arms,” the letter read.
Another section of the letter described a life under house arrest, daily threats and constant observation from cameras and police.
Karimova is a pop star in Uzbekistan who sings under the stage name Googoosha. She is also a jewellery designer and until last year was Uzbekistan’s ambassador to the United Nations.
But her father is now allegedly holding her under house arrest, after having her beaten up for speaking out against his regime.
Karimova, 41, was reportedly put under house arrest with her 15-year-old daughter in February after her father sent up to 30 men to raid her apartment, the BBC reports.
“How naive was I to think that the rule of law exists in the country?” Karimova wrote in her smuggled letter. “I dared to speak up about things that millions are quiet about.”
Karimova was active on Twitter, revealing numerous details about her falling out with her father and the consequences, including the closure of her business and TV stations, the shutting down of her charity and arrests of her supporters.
“It is impossible to live like a human when you are watched by cameras, when there are armed men everywhere and when you are depressed because of what you have seen,” she wrote in her letter to the BBC.
Meanwhile, here is her last somewhat cryptic tweet before her account became inactive late last year. It translates as “Life — boomerang. Sooner or later everyone will be back!”