Musculoskeletal conditions (MSC) have an enormous and growing impact recognised by WHO Europe in “Health 21” yet national health care priorities in most European countries do not include them. The aim of the Bone and Joint Decade is to redress this imbalance by advocacy supported by evidence. To improve the outcome for the individual greater priority has to be given to the provision of existing proven interventions that meet the needs and wishes of the person with a MSC, and better interventions need to be developed through research. Education of public, people with MSC, health care providers, politicians and health professionals is fundamental to changing the negative perception of what can be achieved and in improving standards of care. Any campaign to meet these objectives needs to be supported by relevant data of the impact of MSC and evidence based solutions to reduce this. Key messages that highlight the issues, priorities and these solutions need to be developed for the decision-makers and any other relevant audiences. These messages should be conveyed by the powerful alliance of those with MSC and those who provide their care. The potent image of advocates must be used to attract media attention that is central to the strength of any campaign. Finally targets must be set to measure the success of any campaign. The Bone and Joint Decade is identifying the burden of MSC with the WHO and developing evidence based strategies for prevention with the support of the EU. National and local campaigns are necessary that use this evidence to achieve change and fulfil the aim of the Decade, which is to improve the health-related quality of life for those with musculoskeletal conditions.