THE EAST AFRICAN COMMUNITY HEALTH POLICY ADVOCACY

OPPORTUNITIES

BY JOYCE KEVIN ABALOCOORDINATOR

EAST AFRICAN HEALTH PLATFORMPRESENTATION MADE DURING THE E- LEADERSHIP & POLICY

ADVOCACY RETREAT 19th September, 2013 in Machakos County, Republic of Kenya

Venue: Maanzoni Hotel

Outline of PresentationBackground & Introduction of the EAC integration Purpose and organs of EACEAC State MembersStages/pillars of EAC Integration ProcessHealth Policy agendaMechanism for Public Participation OpportunitiesChallenges and lessons learntAction PlanWay forward

Background (Why Regional Integration?)African states continue to be marginal players in the

Global World. This is due to the small and economically unviable states which produce what they do not largely consume and consume what they do not produce;

Africa is a large continent with a lot of natural resources but lacking in ability to optimally exploit the resources because of under development, human and financial resource;

Small sovereign states have small internal markets and less negotiating capacity in the international arena;

Background (Why Cont..)Infrastructural development remains a big challenge

because of inadequate finances and absence of plans to connect Africa beyond National boarders;

Without proper infrastructure even Private Sector cannot develop because it lacks the required huge financial resources to invest in infrastructure;

Regional integration is therefore, a necessity in order to create large, more viable, stable and economically sensible blocs to save the African people from poverty, disease and perennial conflicts;

In addition, the reality around us is that deeper regional integration has become necessary for sustained economic survival the world over

Benefits of IntegrationA: ECONOMIC BENEFITSEconomies of scale in the exploitation of development

opportunities;Better management of shared resources e.g. Lake Victoria, Mt.

Kilimanjaro and Mt. Elgon;Marketing EAC as a single tourist destination;Free movement of people, goods and labour would spur

economic growth and well being of the region’s citizenry;By pooling resources together there will be the benefits of

comparative advantage, economies of scale and efficient use of public resources;

Avoid duplication of costs borne by individual states for the same services;

A. Economic Benefits Cont..Compete favourably in the global trade arena.With a large population and more varied

resources, more serious local and international investors will be attracted to the region because of bigger internal markets.

The combined revenue base of the five EAC partner states would be better utilized in a more cost effective way.

B. Social and Political Benefits

Cost effective political administrationGood governance, democracy and political

stabilityEnhanced democratic space, devoid of nepotism,

ethnicity and negative tribalismMore viable and cost effective infrastructure

projects e.g. East African Power Master Plan, East African Road Network, East African Railways etc.

Social & Political Benefits Cont.Conservation of the region’s cultural

heritageUse of a common language (Kiswahili)Mutual Trust and Political Good willPeaceful co-existence and good

neighborlinessMore political stability in the regionPeaceful settlement of disputesGood governance

History of the EAC1900 Mombasa established as a Customs collection centre

for Uganda1905 Currency Board set up to issue currency for Kenya and

Uganda1917 Customs Union established between Kenya and

Uganda – Tanganyika joined in 19221948 High Commission established 1961 Common Services Organisation established (East

African Posts and Telecommunications, East African Railways & Harbours, East African Airways, East African Air Aviation Services, East African Development Bank

1967 The Treaty establishing the community Signed1977 The then community collapsed1984 Mediation agreement signed for division of assets

and liabilities

Why the EAC Collapsed Different political ideologies pursued by individual partner states

as follows: Kenya was capitalist, Tanzania socialist while Uganda was mixed.

Influence of the American-Russian Cold War period Disagreements on the sharing of benefits from jointly owned

common services organizations and lack of policy to redress the situation

Low private sector and civil society involvement in the running of the then Community

Greed and short-sightedness on the part of some influential political leaders in EAC

Foreign influence for Economic reasons Lack of uniformity in governance instruments Democracy and

Democratization processes (Dictatorships, military coups, Civil Strife, Human rights abuses)

Lack of mechanism to address corruption, non-respect for Rule of Law, impunity, government’s high handedness

Impact of the CollapsedLoss of jobsLoss of Common ServicesLoss of Free Movement of persons, goods and

servicesNegative Nationalism createdUnhealthy and wasteful competition

flourishedPolitical destabilization by one another

created more tensionSuspicion and Mistrust among member states

Revival of the East African Community

East African Heads Of State Sign The Treaty For The Establishment Of EAC, 30 November 1999

Safeguards against CollapseSAFEGUARDS IN THE EAC TREATY :

Drawing lessons from the experience of the previous EAC, the Treaty Provides for:

1. A gradual approach to the Regional Integration Process

1st Phase - Customs Union (Entry Point)

2nd Phase - Common Market

3rd Phase - Monetary Union

4th Phase - Political Federation

Safeguards Cont…2. De-concentration of Power from the Summit

through a bottom-up decision making process;

3. People Centered and Private Sector Driven integration;

4. Involvement Of Civil Society as key stake holders;

5. Withdrawal Procedures Made more Stringent;

6. Consensus as a confidence building tool.

Introduction About the EACRegional Intergovernmental OrganizationHQ in ArushaTreaty for the Establishment of the EAC Signed 30/11/99Entered into force in 7/7/2000-KE,UG,TZRwanda & Burundi acceded to Treaty in 18/6/07 and became full members in 1/7/2011

EAC Facts & figures

Surface area (incl. water):1.82 million sq. kmPopulation:135.4 millionGDP (market prices):$84.7 billionGDP per capita:$732

Source: EAC Facts & Figures Report (2012)EAC Website: www.eac.int

EAC Vision & Mission

Vision of EAC is a prosperous, competitive, secure, stable and politically united East Africa

Mission is to widen and deepen Economic, Political, Social and Culture integration in order to improve the quality of life of the people of East Africa through increased competitiveness, value added production, trade and investments.

PurposeThe purpose of the EAC is to widen

and deepen co-operation among the Partner States in, among others, political, economic and social fields for their mutual benefit.

Organs of the EACSummitCouncil of MinistersCoordinating Committee-PS’sSectoral CommitteeEast African Court of Justice (EACJ)East African Legislative Assembly(EALA)The Secretariat…..EAC Institutions

Institutions of the EACFrom the 1st EACInter-University Council of East AfricaThe Lake Victoria Fisheries OrganizationThe East African Development BankEast African Civil Aviation AcademyEast African School of librarianshipEstablished Since 2007The Lake Victoria Basin Commission

EAC Institution Cont..East African Science & Technology

Commission;East African Health Research

Commission;East African Kiswahili CommissionEast African Community Aviation &

Security Oversight Agency;Peace and Security.

Member States (Partner States) Republic of BurundiRepublic of KenyaRepublic of RwandaUnited Republic of TanzaniaRepublic of Uganda

Pillars/Stages of the EAC Integration Process

As per Article 5 (2) of the Treaty, Partner States undertook to establish among themselves a:

Customs Union in 2005; Common Market in 2010; Monetary Union-Ongoing;Political Federation of the East African

States.

CUSTOMS UNION 2005

When two or more countries remove tariffs and other barriers on the movement of goods originated from among member states.

Elimination of all non-tariff barriers to cross-border trade.

First basic element/launching pad of a Common Market.

Brief History of Customs Union

Considering the defunct EAC which collapsed in 1977, and degree of trade liberalization 3 EAC founder states were enjoying under COMESA arrangements EAC choose CU in 5- year transition as departure point of integration process.

Article 5(2) of the Treaty on the Establishment of EAC envisages integration among the countries of EA to progress from a Customs Union, to Common Market, then a Monetary Union and ultimately to a Political Federation.

Brief History Cont..The Protocol on the Establishment of EA CU was

signed in March 2004 and came into effect in January 2005.

The main elements of the Protocol are: Elimination of Internal Tariff, Elimination of NTBs ; Introduction of CET regime; Rules of Origin, Competition, Customs Cooperation etc.

Objectives of Customs UnionThe main objectives of the EAC Customs

Union are to: -Deepen the integration process through

liberalization and promotion of intra-regional trade that is mutually beneficial

to all EAC Partner States; Promotion of efficiency in productionEnhancement of domestic, cross border

trade & foreign investment; Promote industry diversification; and Economic development.

Pillars of the Customs Union

Elimination of internal barriers

Single Trade Regime

Single Custom Territory

CETFree Movement

Elimination of internal tariffs

FREE TRADE AREACOMMON TRADE

POLICY WITH THIRD PARTIES

Free Trade AreaEliminated Internal Tariffs but……

Application of charges of equivalent effect on intra regional trade;

Trade taxes not harmonized - over reliance for government revenue;

Lobbies by private sector operatives to impose protective measures on intra regional trade.

Elimination of NTBsTime bound NTBs Monitoring Mechanism in Place Since

September 2008. However….Cumbersome Municipal legal frame work e.g. over 70

legislations governing trade still exist;Cumbersome multiplicity of customs and non customs

border clearance procedures; Application of Rules of Origin despite a fully fledged

Customs Union;High cost of doing business due to dilapidated

infrastructure;Low levels of intra-regional Trade (13% in 2008)

Other NTBs related ChallengesDifferent interpretations of regional lawsLack of mutual recognition of licensesDispute settlement mechanism not

OperationalLack of interface of Customs

administrations

Common External TariffApplication being hampered by…Requests by Partner States to add items to the

sensitive list and exemption scheduleRequests by Partner States for derogation of the

CET through national lists (firm specific)Implementation of national exemption regimes

that vary from EAC exemption RegimeLobbies by private sector for country and firm

specific remissions or to impose protective ratesImposition of levies and taxes of equivalent

effect on imports (PSI)

Free Circulation of GoodsEntails that goods (imports and domestic once cleared at first point of entry) do not suffer any additional customs procedures while entering into another Partner State….ChallengesNational taxes on goods are imposed at point of entry into a country (Final Destination Principle)

Benefits of Customs Union Increased Trade Volumes: Intra – regional trade has

continued to grow across board(US$1.847bn-2005; US$3.477bn-2009 – thus 37.62%-2008 and 28.06%-2009);

Uniformly application of one Customs Management Act (EAC Customs Management Act) by 5 EAC Partner States;

Removal of internal import duty among EAC Partner States. Duty & quota free on goods meeting EAC ROO criteria hence free movement of goods;

Reduction of Non Tariff Barriers following the operationalisation of EAC CU in 2005. Under Article 13 of the CU Protocol, the EAC Partner States have agreed to remove all existing NTBs to trade and not to impose any new ones

Benefits Cont… Uniformly application of EAC Rules of Origin hence facilitate

movements of goods; Uniform application of CET by EAC Partner States to the rest of

the world (Common Trade Policy with Third Parties); Enactment EAC Standard, Quality, Assurance, Metrology and

Testing (SQMT) Act has facilitate trade in the region as the Act provides for mutual recognition of national quality standard marks by each of the EAC Bureau of Standards on products traded across borders;

Enactment of EAC Competition Law and Policy. The law overrides domestic law in so far as cross-border trade is concerned, and in such both law and policy have facilitate fair trade practices in the region;

Adoption of EAC harmonized commodity description and coding systems for goods imported in the EAC region.

Challenges Cont..No legal and institutional framework for collection and accounting of customs dutiesNo universal bond to facilitate free movement of goods ;Limited intra regional trade - raising dependence on customs revenue;No legal framework for Secretariat to sanction in case of failure to implement Customs Instruments

Common Trade Policy

This entails…Common External Tariff applied uniformlyFree circulation of goods including imported

onesCommon Legal and institutional framework

for collection and accounting of customs revenue

Common trade regime with third parties

Single Trade RegimeEntails that Partner States negotiate joint trade pacts with third

parties…(EPA; WTO; Tripartite) Challenges…

Lengthy process or failure in reaching joint positions in trade

negotiations

Conflicting interests – national vis-à-vis regional

Inadequate trained negotiators in national negotiating teams

Negotiating from a point of weakness compared to other party

(due to inadequate technical capacity and financial resources)

The EA Joint Trade Negotiations Act is un-implementable

Dealing with the ChallengesContinuous empowerment of private sector and civil Society

through training and sensitization on regional trade regime;

Assisting partner States to correctly interpret Customs Union

legal instruments;

Supporting Partner States in multilateral and regional

negotiations (EPA; WTO; Tripartite);

Supporting Activities that lead to opening up new trade

frontiers and investment, e.g. AGOA; EAC Investment

conference;

But……East Africans should change mindsets from

national to regional orientationPrivate sector must align business strategies

to the expanded market –corporate strategy should be regional rather than national

There should be deliberate efforts to expand intra-regional trade from 13%

Governments should lead by example - procuring goods manufactured in the region; eliminating NTBs; infrastructure development

But Cont….Partner States should ensure that political

stability prevailsThe institutional structure of the

Secretariat should be reviewed to enable it to met expanded mandate – more executive powers

EAC should continue sensitization on East African integration

EAC Common Market 2010The Protocol establishing the EAC Common

Market was concluded and signed by the EAC Heads of State in November 20th 2009;

It entered into force on 1st July 2010.What is the Common Market?Higher level of regional economic integration of

two or more countries that encompasses the free movement of goods, services, labour and capital plus the right of establishment and residence.

Common Market Cont…It involves free movement of people

goods and services and all factors of production

Involves greater harmonisation of macro economic policies including tax regimes to minimise distortions in the market.

Objectives of the Common MarketAccelerate economic growth and development

of the Partner States through the attainment of the free movement of goods, persons and labour, the rights of establishment and residence and the free movement of services and capital;

Strengthen, coordinate and regulate the economic and trade relations among the Partner States in order to promote accelerated, harmonious and balanced development within the Community;

Objectives Cont.. Sustain the expansion and integration of

economic activities within the Community, the benefit of which shall be equitably distributed among the Partner States;

Promote common understanding and cooperation among the nationals of the Partner States for their economic and social development; and

Enhance research and technological advancement to accelerate economic and social development

Principles of the Common MarketThe Partner States undertake to:

Observe the principle of non-discrimination of nationals of other Partner States on grounds of nationality.

Accord treatment to nationals of other Partner States, not less favourable than the treatment accorded to third parties

Ensure transparency in matters concerning the other Partner States.

Share information for the implementation of the Protocol.

Benefits of the Common MarketEffective, efficient, and sustainable market

enlargement is the principal purpose of regional integration. It results into increased competition, increased specialisation, larger economies of scale and increased efficiency in resource allocation.

The primary benefit is fostering and enhancement of a faster economic growth rate from which a host of (i) economic (ii) social and (iii) political benefits then flow.

Monetary Union

A single currencyWhen two or more states agree on a single

currency for their daily transactions within the Common Market.

Salient Issues

East African Monetary Union (EAMU) process is being informed by the experiences of existing monetary Unions such as the European Economic and Monetary Union (EMU)

The Currency challenges of the EMU have provided lessons that include:-

Lessons Cont..

Need for a sound framework to create fiscal discipline

Need for a strong surveillance and enforcement mechanism of the macro economic convergence criteria;

Need for a reliable timely, and robust statisticsNeed fro strong regional institutions

Lessons Cont…Creation of resilience of the economies such as building

reserves during normal times that will support the hard times

Closer coordination of fiscal policies and the need to centralize some aspects of fiscal policy;

Monitoring the economic and social developments so as to address macro economic imbalances

Plans for reduction of existing national debts to sustainable levels

Needs for a stabilization facility to manage external shocksFull implementation of the Customs Union and the

common Market

Current StatusPreparatory works are ongoing which include:Harmonisation of monetary and exchange rate

policies through the Monetary Affairs Committee (MAC)

Harmonization of fiscal policies through the Committee on Fiscal Affairs (CFA)

Harmonization of Statistics through the Committee on Statistics

Harmonisation of financial sector through the Capital Markets, Insurance & Pension Committee

Current Status Cont… The MAC has made substantial work in among

others creating frameworks for harmonization of Monetary and Exchange rate policiesPayment and settlement systems (EAPS)Banking supervisionBanking and Currency (bank notes and Coins)Information communication technologyFinancial marketsAccounting and Finance

• The Committee on Fiscal Affairs has made significant progress in:

• Excise Tax harmonisation

• Value Added tax harmonisation

• Conclusion of Double Taxation Agreement

• Budget process coordination at regional level through pre-budget and post-budget consultative meetings of Finance Ministers which result into regional coordination of economic policies.

Current Status Cont..The Committee on Statistics in collaboration with

institutions such as the Central banks has initiated programs in harmonization of economic statistics with emphasis on:

Monetary and Financial StatisticsFinancial Soundness IndicatorsHarmonized Consumer Price IndexGovernment Finance StatisticsBalance of Payments StatisticsNational Accounts

Creation of a legal framework for EAMU

• Currently the process of negotiating of a EAMU Protocol is ongoing by a multidisciplinary team of senior government and Central Bank experts (High Level Task Force)

• The Protocol will provide a legal and regulatory framework for the operation of the EAMU.

The issues under negotiations among others include:

• Objectives and scope of the East African Economic and Monetary Union

• Macroeconomic framework including monetary, exchange rate, fiscal matters and the macroeconomic convergence criteria

• Payment and settlement system• Financial system framework• Statistics framework• Institutional arrangements• Transition arrangements• Financing

Strategy to support Negotiation Process• A study on the establishment of the Monetary

Union by the EAC Partner States which was undertaken in collaboration with the European Central Bank and underscored the prerequisites of the EAMU to include: Economic convergence, Legal convergence and market integration.

• Review of the EAC macroeconomic convergence criteria which among others examines fiscal deficit and debt ratios, inflation, external account, interest rates and is being undertaken in collaboration with the IMF.

Strategy Cont..Study on the exchange rate mechanism which

examines the transition to EAMU and during EAMU and is being undertaken in collaboration with International Growth Centre (IGC

Study on monetary policy harmonisation which considers the framework for harmonisation of the monetary policies and is being undertaken in collaboration with the IMF

ConclusionAfter conclusion of the EAMU Protocol, a transition

phase will follow;EAMU has a strong political commitment from the

topVibrant Institutions are necessary for a sustainable

EAMUClose coordination of fiscal policies is paramountEAMU will be robust since it is drawing lessons from

the challenges of the existing currency Unions such as the Eurozone and others on the African Continent

Political FederationFederation-Future-United States of East AfricaWhat is Political Federation?When two or more states come together to form a

super-state under a single political authority.In such an arrangement, federating states cede their

sovereignty and some of their powers to the super-state.

Some known examples of federal states are: USA, Russia, Nigeria, South Africa, United Kingdom, United Republic of Tanzania and the Federal Republic of Germany

Justifications for Political FederationThe need for a central authority to coordinate and

implement decisions made by various organs by the East African Community and to ensure that they are implemented efficiently and effectively;

The Political Federation will enhance the consolidation of what has so far been achieved the integration process;

The Political federation will be used as a mechanism for channeling the benefits of economic integration more equitably among the Partner States.

Justifications Cont……Political Integration quickens economic

integration because it is easier to coordinate one planning unit than several sovereign ones.

A central political authority will generate savings through consolidating rather than duplication of efforts.

There will be higher revenues from the bigger unit. The higher revenues will be more equitably accessible to all citizens under a Political Federation.

Justifications Cont…A Political federation will enable the people

of East Africa to harness diversity for a common goal and re-unite erstwhile cross border communities

The Political Federation will minimize the occurrence of conflicts in the region as well as enhance and legitimize the participation of Partner States in conflict management in the region whenever they occur.

Justifications Cont…The Political Federation will promote better

management and utilization of shared natural resources, better environmental management and the promotion of tourism and investment.

The Political federation will represent EAC as a bigger unit in the global economic arena with a united and stronger voice

Sensitizations & Consultation• Insufficient information dissemination• Tangible benefits to the citizens• Stage by stage cautious approach• Economic disparity• Disparity in education and skills /

entrepreneurship• Peace and Security, cross boarder issues• Land issues vis a vis population ratios and right of

establishment• Power distribution at various levels• Governance issues

Current Status• Study on the state of readiness of the EAC

Partner States towards political federation• Development of the Political federation

framework /models suitable for the proposed United States of East Africa

• Sensitization and consultations of citizens on political federation continues

• Its success depends on the success of the Customs Union, Common Market & Monetary Union

ConclusionEAMU Protocol is expected to be signed by the EAC

Heads of State Summit in November 2013

Health Policy Agenda

EAC Treaty-Chapter 21: Article 118, Cooperation in Health is Covered under Chapter 21 of Treaty: Health, Culture and Social Activities.

Partner States undertake to:-a)take joint action towards the prevention and control

of communicable and non-communicable diseases and to control pandemics and epidemics of communicable and vector -borne diseases such as HIV-AIDS , to co-operate in facilitating mass immunization and other public health community campaigns;

Treaty Provision Cont..a) promote the management of health delivery systems and

better planning mechanisms to enhance efficiency of health care services within the Partner States;

b) develop a common drug policy which would include establishing quality control capacities and good procurement practices;

c) harmonise drug registration procedures so as to achieve good control of pharmaceutical standards without impeding or obstructing the movement of pharmaceutical products within the Community;

d) harmonise national health policies and regulations and promote the exchange of information on health issues in order to achieve quality health within the Community;

Health Department of the EACFive Units Namely;HIV and AIDS, Sexually Transmitted Infections

(STIs), Tuberculosis and Malaria.Medicines and Food SafetyDisease Prevention and ControlHealth System, Research and PolicyReproductive, Adolescents and Child Health and

Nutrition

Broad Health Agenda at EACHuman Resources for HealthHealth Care FinancingPublic Private PartnershipsMaternal, Newborn and Child HealthPrevention and Control of Communicable and

Non-Communicable DiseasesEmergency preparedness and responseSocial Welfare and Social Protection

Current Health Project @ EACOpen Health Initiative Project: Seeks to accelerate

progress towards the goals of the above Initiatives and the Millennium Declaration through regional approaches.

Medicine harmonization Project: seeks to harmonize medicine protocol in the region

Sexual and Reproductive Health Rights ProjectEAC EPI Immunization and Vaccine ProgrammeEast Africa Public Laboratory Networking Project: Seeks

to provide an interactive Geomap of the World Bank - supported East Africa Public Health Laboratories Networking Project (EAPHLNP) sites in Tanzania, Uganda, Kenya & Rwanda.

Situation of Sexual & Reproductive Health Rights in East Africa

According to a study RH components can be defined as an unmet need

Maternal mortality and morbidity remain a serious concern in the region with the Maternal Mortality Ratio ranging from 414/100,000 to 855/100,000 live births with an average of 606/100,000 for the region

The high mortality and morbidity can be explained in part by the fact that the vast majority of births still take place at home and are not attended by skilled attendants whose coverage ranges between 30% (Burundi) and 46% (TZ)

Situational Analysis cont..Major causes of maternal mortality and

morbidity in the region include: haemorrhage, sepsis, complications arising from unsafe/induced abortion, eclampsia, obstructed labour especially among the adolescent pregnancies, as well as indirect obstetric causes such as malaria, anaemia, TB and HIV/AIDS.

Situational Analysis cont..Newborn health is also precarious as reflected in

the high neonatal mortality rates (24 – 37/1,000 live births) which constitutes a third to a half of all infant deaths. Total Fertility Rate remains high in all the partner states (4.7 – Kenya to 6.7 – Uganda) while CPR ranges between 7% (Burundi) and 39% (Kenya) and the unmet need for family planning is high

Situational Analysis cont..Although the demand for reproductive health services

and commodities in Eastern Africa is increasing, findings suggest that there are substantial shortfalls in terms of resources required for meeting RH commodity needs. Most Partner States still rely on contraceptive commodities supplied by donors, which has severe implications for the sustainability of services.

Most reproductive health services are still being paid out of pocket (the new REPOA study, titled "Payments for Maternal Care and Women's Experiences of Giving Birth)

Sexual & Reproductive Health RightsEAC Strategic Plan 2009—2013Sexual & Reproductive Health Components includes:-Maternal, Neonatal & Child HealthFamily PlanningSexual and Reproductive Commodity & SecurityAdolescent HealthSexual Transmitted Diseases Including HIV AIDS & STIsUnsafe AbortionCancers of Reproductive SystemGender Issues & Harmful culture and Traditional PracticesSexual & Reproductive rights of Migrant

Five Key Sexual &Reproductive Health Rights Advocacy projects

*Review/development of the new EAC Sexual & Reproductive Health Rights Strategic Plan

Advocacy for leadership commitment on sexual and reproductive health commitments made by the EAC Partner States

Establish and regularise a forum for sharing, promoting and scaling up best practices on sexual and reproductive health and rights from regional, continental and international experiences;

Identify the key research issues and gaps on sexual and reproductive health and rights and advocate for regional evidence-based advocacy

Mechanism for Public participation opportunities

EAC Treaty ProvisionArticle 7(a) and (d)People-centred and market driven co-operationSubsidiarity(multi-level participation and the involvement of

a wide range of stakeholders in the process of integration)Article 5 (3-e) and (3-g)The mainstreaming of gender in the EAC activitiesEnhancement of the role of women in cultural, political,

economic and technological developmentEnhancement and strengthening of partnerships with the

private sector and civil society in order to achieve socio-economic and political development

Treaty Provision Cont…Article 127 (1) a promote continuous dialogue with the

private sector and civil society at the national and at that of the community to help create an improved business environment for the implementation of agreed decisions in all economic sectors

Article 127 (3) Partner States agree to provide and enabling environment for the participation of civil society in the development activities within the community

Article 127 (4) Secretary General to provide the Forum for consultations between the private sectors, civil society organizations, other interest groups and appropriate institutions of the community (EAC Annual Secretary General Forum)

Current Mechanism for Public Engagement

1. Observer Status: The current framework for direct engagement for advocacy by CSOs and Private Sector in EAC affairs is through the grant of observer status pursuant to Article 3 of the Treaty. Additionally EAC has developed detailed procedure for the grant of observer status. This is convenient for specialized research, education, training and legal civil society organizations. This has its own limitation and challenges. The rules have been criticized as being overly restrictive.

PSOs & CSOs with Observer Status at EAC includes; EALS, EACSOF, EANNASO, EABC, EATUC, EALGA, EAJMA, KITUO CHA KATIBA

Challenges of Observer Status • Restricted to Observing the meeting• Submit at the discretion of the Chair• Very strict rules of procedures for obtaining

observer status1. Registered in all the Five EAC Countries2. Programming for three years regionally3. Subject to consultation and approval of the EAC

Council of Ministers

Current Mechanism cont…2: Consultative Dialogue Framework: through the

EAC Annual Secretary General Forum. 3: Adhoc:a) Wait to be invited by the EACb) Organize joint activities with the EACc) Organize autonomous activities related to EAC

issues and processes and use the findings to influence the EAC

Current Mechanism Cont..

3. Memorandum of Understanding: This is a new mode being explored by the EAC. Again MoUs are appropriate for service provision agencies offering to supplement the efforts of the EAC at local, national and regional levels (Technical Assistance and Research) e.g EASSI, Africa Youth Trust, EALGA

4. Institutional Space: (Permanent Institutional Space in the structures and processes. The Draft EAC Civil Society Mobilization Strategy points to this direction

EAC Structure for Public Policy Advocacy & Decision Making Processes

• Partner States• or• EAC Secretariat

Initiates and • implements

• Experts Group meeting examines

• EAC Secretariat Formats

• Sectoral Committee checks relevance acceptance & applicability

• Summit for Adoption

• Council of Minister &Sectoral Councils

- Budgetary

- Adoption

• Coordinating Committee Structural & Budgetary Implications

Opportunities for Public Participation at EAC

At Partner States/EAC Secretariat level where policy proposition is proposed, CSO could engagement with government department/ministries to influence policy/agenda, researching on the policy agenda for inclusion in the policy proposed, organizing policy debates & public for a to influence the policy agenda

Opportunities for Public Participation Cont..

Expert/group work level where the policy agenda is discussed and drafted. This normally include the government, CSO, PSOs and Experts. Challenged in terms short notification, information shared at short notice and disproportionate representation of government.

Opportunities for Public Participation Cont..

At the expert level, the public should insist on reasonable time for meetings, advance access to workshop agenda and materials, participation in producing materials for workshop discussion, and to provide technical support where possible.

Further, the public should form strong thematic constituencies in order to competently participate in such fora.

Opportunities for Public Participation Cont..

Sectoral Committee Level. The committee receive the scrutinized and agreed policy agenda. The public should be represented at Sectoral Committees and the media could play a role in informing the public on the agenda of the Sectoral Committee with commentaries on the agenda and impact on society

Opportunities for Public Participation Cont..At Coordination Committee Level; the policy

agenda with budget is recommended to the Coordination Committee and its sub committees ‐for scrutiny, adoption and recommendation to the Council of ministers. The public sh’d seek meetings with representatives to these committees at their national government level and make appropriate submissions.

Opportunities for Public Participation Cont..

Council of Ministers. They review and adopt the policy, protocol or decision proposed and recommends to the Summit for adoption

CSOs, PSOs and other interest Groups should seek audience with the Council of Ministers to make their position known on each decision, policy or protocol proposal submitted to them.

Opportunities for Public Participation Cont..At the Summit level; Approval of the policy decision, directs

the Secretariat for implementation, returns to the Council of Minister for ratification if a protocol and returns to the Council of ministers if rejected.

Therefore, the public should put in place appropriate monitoring and review mechanisms;

Mobilize their membership in implementation of the policy/protocol;

Work with EAC and Partner States to restart negotiations on rejected proposals or protocols.

At EALA, the public should engage the general purpose committee on health issues.

Challenges for public ParticipationBeaucracy at the EACLack of information from the EAC Inadequate policy and regulatory framework at the

EAC for the public advocacy engagement much as envisaged by the Treaty Establishing the EAC

Limitation of Observer StatusUncoordinated advocacy platform at regional level

on health and specifically reproductive health rights thus limits to collective action on the issues

Disproportionate representation of Government Representatives

Partner States at different levels of political, social and economic development

Lesson LearntLevel of success in health policy and legislative

development and advocacy depend on ownership & timing of the process and document;

Consensus and confidence building is key in advocacy with the EAC, Partner States for PSOs and CSOs;

Dialogue is the preferred means of engagement

Lesson Learnt Cont…Evidence based submission (Research/ analysis)-

Position paper/policy brief as tool for advocacy engagement;

Regular and consultative meetings with the key stakeholders prior to the initiative or intervention, during implementation and monitoring stages

ConclusionIt is Clear from the experience above that public

engagement with the EAC in strengthening healthy East African Population is paramount if sustainable health and development is to be attained in the EAC region

Public Engagement at the EAC has gained political will from the current leaders but on Health related issues, much still needs to be done;

RecommendationsThe EAC, the Public, EAHP and other major players in

health should intensify public sensitization, education and awareness raising on the EAC integration process and heath agenda at regional level and the engagement opportunities available;

The public should advocate for amendments of the stringent rules provided for obtaining observer status with the EAC;

The public should effectively utilize the current Dialogue Framework opportunities for channeling their advocacy health issues to the EAC and MEACA.

The Public should intensify advocacy on Sexual and reproductive health rights at national levels with the ministry as it one of the unmet needs in the region

Call for Action (way forward)

As a way forward, I call upon the CSOs and FBOs present to take up the opportunities provided by the EAC and influence health policies and related matters proactively.

I also urge that civil society and FBOs make good use of the East African Health Platform as a regional health network and entry point to the EAC.

Merci Boucoup

Thank You for your Kind Attention

Ahsanteni Sana

TOGETHER WE CAN FOSTER BETTER HEALTH IN EAST AFRICA

East African Health Platform (EAHP)