The former USSR is a priority because (a) it is a large area of Europe with little knowledge of headache burden and (b) opportunity exists through a network of investigators created in these countries by the Russian Linguistic Subcommittee of the International Headache Society in June 2004.
Epidemiological studies have been completed in Russia and Georgia. Interventional projects are needed in both countries.
A proposed project in Georgia will be a testing ground for projects elsewhere, with the focus on sustainability. However, Georgian health-service infrastructure does not enable an interventional project to be primary-care based.
The Russian health-care system may not easily support a 3-level service delivery model aimed at all of the general public. More feasible may be employer-based services.
The organization of primary care in public health centres in Serbia is potentially good for primary-care headache services, but restrictions on GP-prescribing, and non-reimbursement of drugs prescribed off-label (including all migraine prophylactics), are high barriers. All drugs can be bought without prescription.
In Bulgaria, primary care is also well set-up to accommodate headache services, and a promising opportunity for intervention is offered by a strong GPs' organization.