Sir Trevor Hassell, President of the Healthy Caribbean Coalition speaks on a panel on a multi-stakeholder engagement during the UN HLM on NCDs on 27 September 2018 © WHO / UN

Mobilising civil society to scale up national NCD responses

10th October 2018

Trevor Hassell, President of the Healthy Caribbean Coalition spoke as a strong voice of NCD civil society during a multistakheholder panel at the 3rd UN High-Level Meeting on NCDs on 27 September in New york. The topic for discussion was opportunities and challenges in engaging government, civil society and the private sector at the global, regional and national levels to promote multi-sectoral partnerships for the prevention and control of NCDS and the promotion of healthy lifestyles... This is what he had to say about how to mobilise civil society to scale up national NCD responses.

Excellencies, distinguished ladies and gentlemen.

The role of civil society in responding to threats to societal development has been recognised for many years, and the call for participation of civil society in response to the NCD threat has been expressed in UN Political Declarations.

Effective mobilisation of civil society is needed in the context in which NCDs are recognised as a global health and development priority - one that requires a Universal Health Coverage approach, the application of the WHO “Best Buys”, and the addressing of the underlying social, commercial, and environmental determinants of NCDs.

For the past 10 years mobilisation of the global civil society movement has been outstandingly led by the NCD Alliance with the attainment of numerous successes which demonstrate the value of civil society in the NCD response.

Regional and national NCD Alliances, for their part, have mobilised civil society in several countries with wide and varied positive outcomes, with the civil society lead, in the Caribbean, taken by the Healthy Caribbean Coalition.

However, despite the many accomplishments which we in the civil society movement appropriately celebrate today, many challenges remain in the effective mobilisation of civil society. Three of which I will highlight today.

Challenges to mobilising civil society

In this regard there is no more pressing and important need and one that frustrates civil society than the lack of sustainable independent financing of civil society organisations. There is a critical need to invest in strengthening civil society organisations - an issue that has been recognised in many fora but has attracted little action.

Linked in many ways to the issue of inadequate sustainable financing of civil society organisations, is the fact that many Civil Society Organisations are technically under-resourced with sub-optimal governance and management structures at country level to facilitate civil society mobilisation and contribution to the multi-sector effort. These organisations often function in silos with health CSOs disease focussed with little participation in the NCD response, and non-health CSOs not at all engaged.

Lastly, an issue that presents an ongoing challenge for the mobilisation of civil society is that of how best to manage relationships with the private sector especially “Big Food and Beverage and Big Alcohol” – the question being whether, “to avoid; or to engage and manage conflict of interest”.

Significant differences of opinion persist I suspect in all countries, and certainly in the highly vulnerable Small Nation States in the Caribbean, where the private sector is often a leading national economic partner, resulting in very challenging conflict of interest issues. Strict engagement principles that manage conflicts of interest, ensure transparency, and limit private sector involvement and influence on public health policymaking, among others, are required.

NCDs: an issue of social justice requiring the highest level of leadership

Excellences, ladies and gentlemen the further mobilisation of civil society requires us to build on our successes even as we meet and overcome challenges, recognising that NCDs present a major social justice challenge, - one that requires highest national political leadership, effective civil society support, and pro-health private sector contribution - one in which the private sector plays a role in partnership implementation, but none in policy development, and one in which incompatible partnerships are rejected, and compatible untapped partnerships embraced.

As the civil society movement mobilises around NCD prevention and control we strongly urge governments to implement commitments made to reduce tobacco use, harmful use of alcohol, unhealthy diets and physical inactivity and to do so in a timely manner to meet the SDGs.

In doing so, I urge Heads of State and Government to include the NCDS in all matters of national development especially around sustainable national financing, and related issues of climate change, trade policies and agreements, agriculture , education and human capital development.

10 years of Caribbean civil society experience as NCD stakeholders

Today the HCC released a report “Celebrating ten years of a civil society regional response to the prevention and control of NCDs in the Caribbean” which records the organisation’s experience in the adoption of a 4 step process and the application of established civil society strategies. A possible civil society resource for multi-stakeholder action.

The report documents Caribbean civil society‘s experience in mobilising full and responsible  engagement and participation of civil society and other stakeholders in the NCD response with an emphasis on Capacity building of health and non-health civil society organisations with inclusion of people at greatest risk and those living with NCDs, and the youth - critical players in effective civil society advocacy andaccountability.

And the report showcases the HCC’s efforts in strengthening national multi-stakeholder dialogue mechanisms of National NCD Commissions and National NCD Alliances as platforms for the implementation of national action plans to attain national NCD targets.

It shares experiences and lessons learned in contributing to Caribbean regional initiatives such as reduction of childhood obesity developed around a civil society electronic Call To Action; advocacy for the creation of a Caribbean Tobacco Free Zone to encourage meaningful legislation to effect tobacco control; initiation of projects aimed at elimination of cervical cancer; actions to control misuse of alcohol developed around an Annual Caribbean Alcohol Reduction Day, and improved hypertension detection, control and treatment.

NCDs: We are in this together

The further mobilisation of civil society requires us to continue to do what we are doing well, to take action to overcome the challenges highlighted, and in settings of, and with, highest level political support, develop and strengthen, national multi-sectoral and inter-sectorial platforms for NCD action, recognising that beyond any other, sustained leadership and commitment at the highest political level adopting cost effective measures of the WHO “Best Buys” is needed to obtain the NCD related Sustainable Development Goals by 2030, by Nation States. The significant active participation of the many Heads of State and Government attending the UNHLM today provides great encouragement to the civil society movement.

In closing, the HCC and the NCD civil society community subscribes to the view partly expressed recently by Her Excellency Inga Rhonda King UN ECOSOC President, to whom we extend special congratulations on her recent election , that “we are all in this together; in its creation and its solutions”.

Thank you.

About the Author

Sir Trevor Hassell is President of the Healthy Caribbean Coalition (HCC), Chairman of the Barbados National Chronic NCD Commission, and Barbados Special Envoy for Chronic Diseases. He is a Fellow of the American College of Cardiology and Fellow of the Royal College of Physicians of London, England, and for many decades, a central figure in the Caribbean NCD response promoting the importance of multisectorality and a whole-of-society approach to prevention and control of NCDs. He was actively involved in the advent of the Port of Spain Declaration on NCDs and is a recognised leader regionally and internationally in championing and leading all aspects of civil society’s engagement in the NCD response. He has been extensively involved in NCD policy making, wellness programmes and interventions, and civil society capacity building and advocacy across the region. In 2013 Sir Trevor was appointed to the Order of Barbados as a Knight of St. Andrew in recognition of his outstanding contribution to the medical profession and public health in Barbados.