The public-health challenges posed by headache disorders are similar throughout the world. Although they are common and disabling, headache disorders are under-recognized, under-diagnosed, and under-treated. Headache-related burden that could be alleviated is not; it therefore persists at a high level everywhere. This paper describes the World Health Organization's (WHO's) response to this global problem. There are several contributors to the problem. Most of them have their roots in educational deficiencies. Little priority is given to headache despite increasingly clear evidence that this is the wrong approach. It is wrong from a public-health perspective, and it is wrong in view of the seriously adverse economic consequences of headache disorders. Educational failures cause this evidence to be unseen or ignored. First among the contributing factors is that people with headache do not consult doctors: only a minority of those affected seek medical help, even where it is potentially available. This seems strange, but an important reason for this is a lack of general awareness in many parts of the world-that headache disorders have a biological basis and should receive medical attention. A second key reason is that those who do seek help are likely to encounter doctors less than willing to treat them and be sent away discouraged. This, too, has a number of causes, but chief among them, and self-perpetuating, is that doctors generally are not well trained to treat headache. Poor knowledge and understanding of headache leads to misdiagnosis, mismanagement, and poor outcomes which, often, not only waste health care resources but also make the initial problem worse-adding to headache-related burden. Doctors find this discouraging also. Even where it is not so, and doctors are trained and genuinely interested in headache, they are commonly constrained because resources are not allocated to its management. Without tools for the job, they may find little is possible.
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