Recent studies showed that in sub-Saharan Africa (SSA), where more than 1 billion people live, headaches are at least as prevalent as in western countries (1). Local healthcare systems, mainly based on few and overcrowded city-hospitals with very few neurologists (one neurologist per 3–5 million people in SSA) are insufficient to manage the condition. The HIV/AIDS epidemic in SSA has led to the construction of many HIV health centres outside hospitals where millions of HIVþ patients go all their lives to treat their illness. These HIV centres have become a platform to combine treatment for both non-communicable diseases (NCDs) and HIV, as advised by the United Nations (2). Headaches could also be managed at existing HIV centres in SSA but some basic requirements are necessary to achieve that goal, among others: Education and training of local personnel, telemedicine to enhance the quality of clinical activity, adequate pharmacies to guarantee drug delivery, strategies to increase both patients’ retention and access to treatments. Is this possible in SSA? Disease Relief through Excellent and Advanced Means (DREAM) is a health program started in 2002 to treat HIV/AIDS in SSA. It operates in 11 SSA countries with 48 health centres and 26 laboratories following more than 500,000 HIVþ people (3). More than 10,000 African personnel, including clinical officers, doctors, nurses, and biologists, have been trained by DREAM in over 30 local and pan-African training courses. DREAM personnel are also trained to manage NCDs such as cervical cancer, arterial hypertension, diabetes and other diseases. They also have basic training in neurology and could also receive education on headaches. A robust telemedicine system supports DREAM clinical activities. Neurologists can help in differentiating primary versus secondary headaches remotely, and teleconsultation on electrocardiograms could help to exclude conditions contraindicating beta-blockers and/or amitriptyline for migraine prophylaxis. DREAM pharmacies are used to deliver drugs to treat chronic conditions such as HIV, tuberculosis, arterial hypertension, and diabetes, including beta-blockers (propranolol and atenolol) and amitriptyline, used in DREAM to treat arterial hypertension and neuropathic pain respectively. Paracetamol, naproxen and ibuprofen, agents used to abort migraine attacks, are also available there. In those poor regions, DREAM delivers all services free of charge and this facilitates access to care. Increasing population awareness of certain illnesses is of crucial importance in SSA. DREAM personnel meet patients in villages, workplaces, markets, maternity clinics, hospitals, religious associations and so on to inform people about HIV, offering a test and treatment; information on some NCDs is also