The Problem Summarized
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"The discoveries of the last 15 years - so exciting in the developed world - do not touch a large majority of the world's headache-blighted lives."
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Headache disorders are real and often lifelong illnesses. They are very common, affecting men, women and children in every part of the world. What is more, they are disabling.
In the World Health Report 2001 [reference 1], the World Health Organization ranked migraine among the top 20 causes in the world of years of healthy life lost to disability. Migraine is the cause of an estimated 400,000 lost days from work or school every year per million of the population in developed countries. Migraine harms family and social relationships and damages quality of life.
Migraine, however, is only one of several headache disorders with public-health importance. The others include tension-type headache and a group of disorders, including medication-overuse headache, that are characterized by headache occurring on more days than not (sometimes without remission). Together, these are believed to be responsible for even more disability than migraine [reference 2]. If this is so, headache disorders collectively are in the top ten causes of disability worldwide, and the top five in women.
That is one side of the problem.
A second is that, although good health care can greatly reduce this burden, it still persists everywhere. In some places it is not lessened at all.
The principal reason is that health-care systems, which should provide this care, simply do not reach many who need it. This abject health-care failure has its roots in education failure at every level, and in the resulting and widespread lack of understanding.
A third side of the problem is perspective. Research into disease mechanisms is unquestionably important if they are to be understood and new and more effective treatments made available. Yet we know that the discoveries of the last 15 years - so exciting in the developed world - do not touch a large majority of the world's headache-blighted lives.
This is why headache matters as a public-health imperative.
References
1. World Health Organization. The World Health Report 2001. Geneva: WHO, 2001.
2. Stovner LJ, Hagen K, Jensen R, Katsarava Z, Lipton R, Scher AI, Steiner TJ, Zwart J-A. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia 2007; 27: 193-210. [view document]