Making change happen
The first formal national initiative is in Spain, launched with government recognition in July 2004. It has stated objectives at present limited to Steps 1-5. It will later be supported through to Step 7.
Elsewhere, wherever knowledge is insufficient of the scale and scope of the local burden attributable to headache, epidemiological studies will be undertaken to fill that gap. Unless the problem is known and understood, effective solutions to it cannot be proposed.
An epidemiological study in Georgia, part of the Caucasus and of the former USSR, has been completed. Conducted by the Working Group for Georgian Objectives in collaboration with the Russian Linguistic Subcommittee of IHS, this was the first epidemiological study of the Campaign and followed a successful pilot exercise in Tbilisi.
The methodology developed for this may have application in other low-income countries.
In India, the prevalence of headache disorders may be high but good epidemiological data do not exist. A Working Group for Indian Objectives has been formed and the protocol for an epidemiological study is being developed.
China is a priority because of its size and because the prevalence of migraine there is probably underestimated, significantly diminishing the global measurement of the burden of headache. A Working Group for Chinese Objectives is being formed.
Other priorities include Russia and countries of Africa and South America. A Working Group for Russian Objectives and a Working Group for African Objectives are being formed.
Interventional programmes will follow. In demonstrational projects, Lifting The Burden will, country by country, adapt the solution to the problem as it exists locally.
The solution will always have education at its centre, and it will call upon the clinical management supports being developed on the Global front.
But it will also require health service delivery and organization that will, generally, depend upon local government to put in place. That is why government commitment is needed. Lifting The Burden will work with local governments and other country policy-makers, as well as with WHO's Regional Offices, to plan and implement each of these solutions, and make them achievable with locally available resources and within a defined term.
In particular, through education, Lifting The Burden will aim to overcome the barriers to care as the first and most important requirement for alleviating burden. It will do this through a range of educational initiatives at all levels, from the general public through health-care providers to governments and health-policy makers, thereby:
- increasing the reporting rate by people with headache,
- improving doctors' understanding of the need for medical care, and promoting better diagnosis and care, and
- making health-policy makers aware of the socioeconomic benefits of adequately resourcing good headache care.