When Italy organised a conference focused on the Middle East, the Gulf and North Africa, it promised to look beyond the turmoil roiling the region and instead promote a "positive agenda".

But many of the 45 heads of state, ministers and business leaders who attended the event over the past three days saw little future cheer.

Qatari Foreign Minister Sheikh Mohammed bin Abdulrahman al-Thani, captured the gloom, bemoaning "a lack of wisdom" in the region, with "no hope" on hand for ordinary people hoping for an end to years of conflict, upheaval and sectarianism.

"Maybe I have presented a dark picture, but it is not as dark as I have explained, it is darker," said Thani, whose country is suffering an economic blockade by its Arab neighbours, which accuse Qatar of supporting terrorism.

Qatar denies the accusations and the crisis has pushed the tiny, gas-rich state closer to Shi'ite Muslim Iran, the regional rival to Sunni Muslim Saudi Arabia.

The foreign ministers of both Iran and Saudi Arabia addressed the conference, taking turns to trade barbs.

Maybe I have presented a dark picture, but it is not as dark as I have explained, it is darker. - Qatari leader al-Thani

"Since 1979, the Iranians have literally got away with murder in our region, and this has to stop," Saudi Foreign Minister Adel al-Jubeir said on Friday, accusing Tehran of interfering in the affairs of numerous Arab states, including Syria, Yemen and Lebanon.

A day earlier, on the same stage, Iranian Foreign Minister Mohammad Javad Zarif accused Saudi Arabia of blocking ceasefire efforts in Syria, "suffocating" Qatar, destabilising Lebanon and supporting Islamic State.

He also dismissed suggestions that Tehran was meddling in the affairs of its troubled neighbours or that it should stop supporting militia groups, like Hezbollah in Lebanon.

Destruction

Casting around for reasons to be positive, most speakers pointed to the defeat of Islamic State, which used to rule over millions of people in Iraq and Syria, but now controls just small pockets of land after months of fierce military assaults.

However, officials warned the group would not die easily.

"It has been defeated as a military force on the ground, but it is likely to go back to cities to create destruction and terror," said Arab League Secretary General Ahmed Aboul Gheit, predicting the militant group could still be around in 10 years.

Iraq's foreign minister bemoaned the destruction it had left in its wake, and called on the world to unite to help rebuild his country in the same way they had come together to fight IS.

"The world owes this to us," said Ibrahim al-Jaafari. "A lot of destruction demands a lot of reconstruction. Mosul is not at all what it was like before. It used to be beautiful. It had a university. Now it is just ruins."

Egypt's Foreign Minister Sameh Shoukry warned that IS fighters fleeing Syria and Iraq had come to his country, where an attack on a mosque in Sinai last month had killed more than 300 people. They were also heading to lawless Libya, he said.

Amidst all the talk of war and chaos, there was little mention of diplomatic efforts to restore peace to the region.

"At a time when you have so many sources of tension, so many fuses, so many humanitarian catastrophes, you also have so little diplomacy," said Robert Malley, vice president for policy at the non-governmental International Crisis Group.

Underscoring this point, no one from the White House administration took part in the conference -- a signal some diplomats put down to a general disengagement from the Middle East by President Donald Trump. Last year, the then secretary of state, John Kerry, participated.