Lifting the Burden

Hundreds of millions of people worldwide carry the burden of impaired health, disrupted lives and lost opportunities due to the disabling nature of headache disorders. This burden was highlighted today in Copenhagen when the World Health Organization (WHO) announced, in partnership with three major international non-governmental organizations (NGOs), the launch of their global campaign to reduce the burden of headache worldwide which is entitled Lifting The Burden.

This partnership in action brings WHO together with the World Headache Alliance (WHA), which works and advocates internationally on behalf of headache sufferers and their families and communities, and the International Headache Society (IHS) and European Headache Federation (EHF), which represent doctors and scientists committed to understanding and alleviating headache disorders.

The global campaign aims to understand why headache disorders receive so little priority for health-care throughout the world despite the very evident burden they impose on people and society. It aims to improve access to health-care services offering correct diagnosis and effective management whilst enhancing social understanding of headache disorders. Its scope is worldwide, recognizing that gaps exist everywhere between need for and provision of health care for headache, and will focus on both developed and developing countries.

At the press conference in Copenhagen today, Dr Timothy Steiner, chairman of the global campaign committee, declared on behalf of the partners:
"The time has come to ask ourselves where our responsibilities lie, and what should our priorities be. 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."

"We recognize the scale of the global problem we face in wishing to relieve the burden of headache in the world. We believe that harnessing WHO's experience, know-how, contacts and resources will open doors, and together we can address problems and propose and test solutions in every region of the world."

Headache disorders are a global public health calamity. Dr Peer Tfelt-Hansen, president of IHS, explained:

"They are common neurobiological and often life-long conditions occurring throughout the world that affect men, women and children. They have been shown to cause a huge burden of disability. WHO ranks migraine as one of the top twenty causes of years of healthy life lost to disability. And migraine is but one headache disorder - all headache disorders together cause at least double the disability of migraine alone."

Effective treatments exist. For the vast majority of people with headache, good management that alleviates symptoms and reduces disability does not require expensive tests, equipment or specialists. But it does require understanding by those who treat it, and that is achieved only through education.

Yet, in many countries, headache disorders are not recognized as health conditions requiring any care. Everywhere, headache disorders have low priority when it comes to allocating health-care resources and a consequence of this is that education also is lacking. Treatments that could be available are not, whilst mismanagement commonly makes the problem worse. The overuse of medications is the cause of daily headache in large numbers of adults and children.

Dr Fred Sheftell, founder and chairman of WHA, explained:
"Powerful humanitarian and economic arguments exist for making headache a health-care priority. We have to build public awareness about the impact of headache as serious disorders that can disrupt quality of life and, at its worst, destroy quality of life for chronic sufferers. Headache disorders are neurological conditions that respond to treatment. Unfortunately, too many people are not getting the help they need."

Lifting The Burden sees education as the key to better care and reduced burden of headache. It will set priorities and find, region-by-region, effective and affordable solutions that promote the availability of better treatment which in all cases will depend upon awareness of headache disorders and the need for their correct recognition and diagnosis, appropriate lifestyle modifications, proper use of cost-effective pharmaceutical remedies and, importantly, avoidance of mistreatment. Dr Steiner said:

"Through education, better care and reduction of burden not only are possible but also can be cost-effective through more efficient use of currently allocated resources or by reducing the consequential financial costs of headache. But in each region we need local people to work with, and agencies with influence to effect or support change wherever change is both necessary and possible."

Lifting The Burden will develop sound evidence to underpin the humanitarian and socioeconomic arguments that headache should be high amongst priorities for health care, and use these to persuade local health-care policy-makers. WHO, WHA, IHS and EHF are establishing an observatory of headache throughout the world. Adding to the data on migraine compiled by WHO for the World Health Report 2001, a complete review of all the epidemiological evidence will produce a headache map of the world. Where there are gaps in our knowledge, particularly in developing countries studies will be set up to fill them.

Lifting The Burden will seek local solutions to the problem as it exists in each region, having regard for cultural and economic realities in different countries. Priorities will be set not simply by identifying the areas with greatest need but also by considering where action can achieve the greatest benefit. Integrated policy and service development will come from within each community, building upon locally available knowledge and resources.

Educational programmes will take advantage of those already provided by IHS, EHF and their member societies for health-care providers and by WHA and their member organizations for people directly affected by headache disorders and the general public. These programmes will advocate against stigma and discrimination which isolates headache sufferers.

Lifting The Burden will prove its case. Regionally-implemented demonstrational projects will test proposed solutions, evaluating their effect in terms of reductions in the measurable population burden attributable to headache disorders whilst assessing the cost of putting them in place.

_{For further information journalists can contact:
Matthew Hebdon
Atrium Communications
34 Telford Place
Chelmsford
UK
Tel: +44 1245 280 067
Fax: +44 1245 280 766
Email:matthew.hebdon@atriumhealth.com}