TBILISI, Georgia — Almost every day, Giuli Alasania makes the drive down a dusty highway through the Georgian capital to visit her son, former President Mikheil Saakashvili, in hospital.

“It’s ironic,” she says, fussing over the plastic pots of stewed beans and salads she is bringing for his lunch, “when he was president, he built this clinic. Now he’s dying in it.”

Ailing and imprisoned, Saakashvili holds Georgia’s future in his hands.

Confined to his hospital room, he told POLITICO that his life or death will have an enormous impact on whether Georgia has a realistic chance of joining the European Union, in a scribbled note passed to his legal team.

“I am fighting for my life and for this country,” he wrote, “of course, they might still drive me to a lethal outcome and it would be a terrible signal in this hybrid war for the entire region and embolden autocracies and wannabe despots.”

Saakashvili’s enormous influence — a decade after he left the presidency — comes despite his controversial record as leader.

In 2003, he led the Rose Revolution that overthrew a post-Soviet government run by oligarchs with the promise of a crackdown on corruption and an opening to the West. He even changed the constitution to enshrine “full integration” into both the EU and NATO.

“After the Rose Revolution, there was this mood among young people — we were all motivated, we believed we had a chance to build Georgia up and make it something different to what had happened before,” said Eka Gigauri, head of anti-corruption NGO Transparency Georgia. “We decided we were not just a regular post-Soviet country, and that the EU and NATO was the only choice for us. We were ready to dedicate everything we had for that.”

But in 2008, Saakashvili led his country during a disastrous war with Russia, and his increasing authoritarianism alienated many of his original supporters, including Gigauri, who quit her role in the civil service to hold the state to account from the outside.

The bombastic center-right leader was voted out in 2013 and left for Ukraine — becoming governor of Odesa and then head of President Volodymyr Zelenskyy’s National Reform Council. A Georgian court found him guilty in absentia of abusing his power by pardoning police who beat an opposition lawmaker. He was stripped of his Georgian passport and sentenced to six years behind bars. Few expected Saakashvili to ever return.

They underestimated his capacity for showmanship.

In 2021, the homesick politician illegally sneaked back across the border, touring the countryside, eating his favorite khinkali dumplings and daring the authorities to arrest him — which they soon did. The increasingly erratic former president declared he was a political prisoner and went on a hunger strike to demand his release. He called it off after a few weeks as Russia invaded Ukraine.

Since then, though, the 55-year-old’s health has dramatically deteriorated.

“He has lost so much weight I hardly recognize him,” said his mother. “I bring him the smallest size of trousers and even those are too big. He has confusion, he can’t remember what happened a few hours ago. Tests show he has heavy metals, mercury, barium and bismuth, and cyanide, in his body.”

Life and death

In life, Saakashvili may have failed to bring about the deep and lasting reforms Georgia would need to join the EU — but in death, he could sink the project for good.

“Relations with the international community are already in a deep freeze as a result of the Georgian Dream party’s embrace of Moscow,” said David Kezerashvili, who served as Saakashvili’s defense minister during the 2008 Russian invasion. “And the prospects of European Union membership would appear to be crumbling before our eyes.”

After Saakashvili left power, the country shifted in a more pro-Moscow direction under the ruling Georgian Dream party, founded by billionaire Bidzina Ivanishvili. Although Ivanishvili publicly left front-line politics, he is widely believed to call the shots and give orders to Prime Minister Irakli Garibashvili.

Even though the Kremlin and its local allies control a fifth of Georgia’s territory, the government refused to impose sanctions on Russia in the wake of Moscow’s full-blown invasion of Ukraine. Instead, it has been accused of turning a blind eye as the country becomes a waystation for sanctioned goods moving from the EU into Russia, cashing in by circumventing restrictions.

In a sign of warming ties, the Kremlin scrapped a ban on direct flights to Georgia and relaxed visa requirements for its citizens. Russian holidaymakers now fly to the sunny capital and its seaside resorts, despite public protests and a warning from Georgian President Salome Zourabichvili.

In May, Garibashvili came under fire after claiming the war was the result of Ukraine’s desire to join NATO, echoing Russian leader Vladimir Putin’s own talking points.

According to a report from the European Council on Foreign Relations, Ivanishvili “appears to be largely responsible” for Tbilisi’s pro-Moscow tilt. “Through his control of the Georgian Dream party and the government, Ivanishvili may be attempting to maneuver Georgia into Russia’s sphere of influence,” it says.

Pro-EU population

The government’s shift of direction clashes with popular views; blue EU flags hang from apartment balconies and government buildings across Tbilisi.

A nationwide poll in April by the International Republican Institute found that 89 percent of Georgians support joining the EU, the highest number recorded for years. But only 38 percent of the 1,500 people sampled think the current government is following a “pro-Western” foreign policy.

Outside the hospital, an activist keeps a round-the-clock vigil, sleeping in a car decked out with placards reading “free Misha!”

There is also international concern for the fate of Saakashvili. Zelenskyy wants the Georgian government to allow the former president to come to Ukraine.

“Russia is killing Ukrainian citizen Saakashvili at the hands of the Georgian authorities,” he tweeted earlier this month, after court photos showed an emaciated Saakashvili. “I urge our partners to address this situation and not ignore it and save this man. No government in Europe has the right to execute people, life is a basic European value.”

The U.S. State Department said late last year it is “very closely following” Saakashvili’s treatment. Meanwhile, the European Parliament earlier this year urged Tbilisi to release Saakashvili, warning his treatment is “a litmus test for the Georgian government’s commitment to European values and its declared European aspirations, including EU candidate status.”

EU candidacy clash

Georgia’s EU hopes are already in deep trouble.

In June 2022, the EU granted Ukraine and Moldova candidate status, but stopped short of offering the same to Georgia — instead prescribing a package of 12 recommendations for reforms.

Last year, a European Parliament report warned Georgia has “seriously backslided with respect to the basic democratic principles and key political commitments” it undertook as part of an association agreement with the bloc.

“The rule of law is backsliding from the progress that the Georgian Dream achieved during the first years of their governance,” said Vakushti Menadbe, associate professor at Ilia State University law school, adding: “They try to create illusion that there is progress, however, the proposed reforms do not drive towards more democratization.”

While the government insists Saakashvili is receiving adequate care and must serve his sentence, allies of the former leader are pushing for an EU-backed delegation to investigate his health.

Giorgi Chaladze served as a former deputy culture minister in Saakashvili’s government and now acts as his personal lawyer. “The EU agreed in February to send a mission to look into his treatment and health,” he said, sitting in an office surrounded by paperwork covered in the former president’s scrawl.

A long-awaited Polish medical mission was in Tbilisi earlier this month, but has yet to publicize its findings. Aside from them, Saakashvili’s only visitors are his mother and his lawyers.

Every day, Chaladze or another member of his team visits the hospital with print-outs of tweets and messages from well-wishers. One, from former Belgian Prime Minister and MEP Guy Verhofstadt, calls on the authorities to “stop the inhumane treatment” and “release him now!” Saakashvili has jotted instructions on a corner of the page to retweet the post.

International fallout

The European Commission is expected to publish its 2023 Enlargement Package in October, which will assess progress in key reform areas and potentially open the door for Georgia’s EU candidacy.

In a statement shared with POLITICO, Georgia’s Mission to the EU denied that momentum has stalled on its potential accession. “Georgia has earned to be a candidate for EU membership both in terms of its technical readiness to take this step and in terms of the geopolitical choices it has made over the last 25 years,” it said.

However, with concern growing over the former president’s treatment, Brussels is looking increasingly unfavorably on Georgia’s EU hopes, argues Viola von Cramon, a German Green MEP and a member of the European Parliament’s Committee on Foreign Affairs.

“Saakashvili was definitely not a democrat, but he knew what he was fighting for and knew what it meant to have an attractive country, to bring young people back, to pay people properly in the public sector,” she said. “Now the influence of Russia is remarkable. If he dies in prison, the message it send[s] to the EU is absolutely zero.”

Back in her apartment, surrounded by portraits and family photographs of the man who once led the country, Alasania said she’s come to terms with what could happen to him.

“My son isn’t afraid to die,” she said. “He’s afraid that Georgia might die.”