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This report is an abridged version of the report on the the Joint WHO and League of Arab States regional consultation to enhance the role of civil society organizations in the health and sustainable development agenda in the Eastern Mediterranean Region held in Cairo in Cairo on 23–24 August 2015. The complete report is available at: http://applications.emro.who.int/docs/IC_Meet_Rep_2015_EN_16665.pdf?ua=1

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From MDGs to SDGs

September 2015 was the target date set for achievement of the Millennium Development Goals (MDGs) and the United Nations (UN) has been working on a post-2015 development agenda. The process of shaping the agenda of the Sustainable Development Goals (SDGs) that are replacing the MDGs has been led by Member States with the involvement of a broad participation of groups and civil society organizations. Since 2014, a number of civil society organizations worldwide have been closely involved through consultations and publications of position papers on governance, health, gender, equity and children, among other issues. There are 17 SDGs and 169 targets that build on the work done on the MDGs. Goal 3 (“Ensure healthy lives and promote well-being for all at all ages”) addresses health specifically, and covers four of the main regional health priorities: universal health coverage, maternal and child health, communicable diseases (HIV/AIDS, malaria, tuberculosis) and noncommunicable diseases prevention and control. The other goals refer to the social determinants of health.

The SDG agenda poses several challenges and governments will be unable to make progress alone. Other stakeholders, including civil society, will have an important role to play. The SDGs contain cross-cutting issues beyond health, providing an opportunity for cross-sectoral collaboration and the development of multisectoral partnerships with key stakeholders. Mainstreaming health in the SDGs will require the involvement of civil society organizations to ensure that upstream determinants of ill-health are not ignored.

The MDGs created opportunities for the involvement and engagement of civil society organizations to ensure that community priority needs were considered in health and political agendas. It is important that the SDGs build on the work of civil society organizations and make use of existing platforms and networks. Since civil society participated in the development of SDGs at a global level, it is important that civil society organizations play an active role in implementation at country level.

In this context, the League of Arab States has been holding a series of consultations in preparation for the launch of the “Arab decade for civil society organizations 2015–2025”. The Decade provides a platform for strengthening and mobilizing civil society organizations in the Arab region to become effective partners in achieving the SDGs. WHO is cooperating with this initiative by helping to identify the specific role that civil society organizations can play in achieving SDG 3 (the health goal).

As part of this, and in an effort to strengthen the engagement of civil society organizations in the Eastern Mediterranean Region in advancing the health and SDG agenda, the League of Arab States and the WHO Regional Office for the Eastern Mediterranean held a joint regional consultation on 23 and 24 August in Cairo, Egypt, bringing together representatives of the main civil society organizations in the Region dealing with health and its determinants.

The main objectives of the consultation were to:

understand the current domain of activities of civil society organizations and the available capacities;

identify gaps and challenges in the current civil society organization work in the Region;

discuss how to overcome these challenges; and

deliberate on the main role of civil society organizations in the SDGs and in addressing the five regional health priorities.

The consultation was attended by 20 representatives of civil society organizations from Egypt, Jordan, Kuwait, Morocco, Oman, Palestine, Saudi Arabia and Tunisia, in addition to regional civil groups and networks, including the Arab Scout Regional Office.

The role of civil society organizations

Civil society organizations have a key role to play in progress on the health-related SDG agenda, including in health literacy, advocacy, social mobilization and service provision, especially in countries in crisis and emergency situations. In the Region, civil society organizations vary in number according to country, but are increasing in number and influence. They play a crucial role in addressing population health problems, providing institutional vehicles to address community needs and expectations, and complementing government action in implementing programmes not considered to be a priority or targeting marginalized population groups. Civil society organizations also provide frontline services in countries with acute crises where governments are weakened or partially-absent (several countries in the Region). They facilitate community interaction with services such as those for hygiene, water and sanitation, support access to vaccines and promote health through information dissemination, such as in Ebola virus disease outbreaks and natural disasters, and for smoking prevention and promotion of healthy diet and physical activity. They also influence policy development, for instance through the Framework Convention on Tobacco Control and in HIV/AIDS, and contribute in resource mobilization, including for polio eradication and girls’ education.

Impediments and challenges

The role of civil society organizations and the importance of partnership with civil society are not well recognized by governments in the Region. There is a lack of legal frameworks for the establishment of civil societies and networks. As a consequence, inadequate trust exists between governments and civil society, and coordination is difficult. Moreover, little use is made by government of the results of the research conducted by civil society organizations.

Additionally, there is a weak culture of volunteering in the Region and poor understanding of its importance in development. Furthermore, cultural and social norms exist that prevent specific groups from participating in civil society.

Specific challenges related to civil society organizations include weak strategic planning, inadequate staff capacity, and weak governance and management, with often limited transparency in funding. There is an absence of tools to support inclusion of all members to ensure democratic processes and weak team work towards common goals. Working conditions do not attract high calibre and skilful staff, and there is a lack of plans for capacity-building of staff. The focus of work is often on activities rather than programmes and is frequently donor- rather than need-driven. There is weak utilization of information technology for database building and weak self-assessment at the institutional and performance levels, with no or limited tools being used. In general, there is a lack of mechanisms for collaboration between civil society organizations.

Next steps

The consultation concluded by offering recommendations for the League of Arab States and WHO and highlighting the next steps needed to move forward on enhancing the role of civil society organizations in the health and sustainable development agenda (Box 1).

To the League of Arab States

1. Finalize the criteria governing the relationship between civil society organizations and organs of the League of Arab States with a view to fostering close cooperation between civil society and the League.
2. Organize regular forums, workshops and training courses for civil society organizations in Arab states to raise awareness of the SDGs and promote civil society participation in them.

To WHO

1. Support the development of criteria for assessment of civil society organizations, particularly for those that are health-related.
2. Establish a network of civil society organizations working in the field of health in the region.
3. Map health-related civil society organizations and create an online database.
4. Raise the awareness of health-related civil society organizations on the SDGs and develop discussion on them through regular forums to address problems.
5. Support capacity-building of civil society organizations through organizing training-of-trainers courses to ensure sustainability.
6. Build capacities in health priorities, proposal writing, project planning and implementation, and promotional campaigns.
7. Support the establishment of liaison offices at ministries of health to act as an interface with civil society organizations.