Interventional programmes, especially in primary care (Campaign stage 3), must provide guidance on management. Most countries of the world have none. Cornerstone principles of treatment are more feasible than guidelines.

Lifting The Burden has collaborated with a working group of the European Headache Federation to produce evidence- and consensus-based European principles of management of the headache disorders important in primary care. This was done by harmonizing existing national guidelines.

In time, these will be adapted for other regions, again harmonizing with national guidelines where these exist.

Click here to view the pdf file European principles of management of common headache disorders in primary care.

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Lifting The Burden is collecting and submitting evidence to WHO on medicines that should and should not be included in their list of essential medicines. This list has political weight and is persuasive to national health policy-makers.

The list of essential medicines has the subject heading "Migraine", but other headache disorders are not currently represented.

For acute migraine, ergotamine was deleted in the 2005 review, leaving only acetylsalicylic acid, paracetamol and ibuprofen for children. Adding a triptan would increase availability of and access to at least one triptan in many countries worldwide, with considerable potential for improving care.

Propranolol is the only drug listed for migraine prophylaxis.

Lifting The Burden will develop arguments for broadening the scope to include tension-type headache, which is as burdensome worldwide as migraine.

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To improve the evidence base for all headache treatments, Lifting The Burden is supporting, both financially and intellectually, the headache sub-group within the Pain, Palliative and Supportive Care (PaPaS) Group of the Cochrane Collaboration.

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