In the country I am currently living in, which I would rather not name due to personal circumstances and Internet search engines (hint: it is in Asia and is about to be surpassed as the world's number two economy by another Asian country), the situation is pretty bad.
Recognition by the medical establishment is close to zero; the vast majority of doctors assume it is some type of psychiatric condition; in fact, the MDs who tend to have at least heard about CFS are psychiatrists. Public awareness is also close to zero.
Waiting lists for real doctors who have even heard of the disease are interminably long. Once one is fortunate enough to get diagnosed and see one of these rare birds, one is met with advice for CBT and GET based on the UK "evidenced-based" (in their words) model. No extensive testing is performed unless skillfully requested. Doctors are not straight with patients about the prospects of recovery. They tell you most people get better and that it's critical to stay positive.
To say treatment is conservative would be an understatement. One standard protocol exists for all patients who are diagnosed with "CFS" that consists of high-dose vitamins and a TCM mixture that is used in a wide variety of ailments. The only customizing that is done is for sleep medication, if needed, and antidepressants (which are often suggested despite the absence of depression).
I have not heard of any doctor experimenting with anti-virals like Dr. Peterson or addressing gut issues per Cheney and others. Ampligen is not being considered (although I read somewhere that a pharmaceutical company was exploring its application in another disease, perhaps it was avian flu), nor is any other drug that seems to be offered on an experimental basis in US and Europe (e.g. immune modulators, LDN, stem cells).
The cult of MD worship in this country is entrenched. Patients do not question doctors' expertise or advice or knowledge, period, and when questions (e.g. that ME/CFS is not a psychiatric condition or the dangers of GET) are raised even in the most calm, matter of fact and very polite manner (very rarely, I suspect from the reactions I have gotten from doctors), it is politely - or not so politely - ignored. Reactions to the spectacle of a young female patient standing up for herself have ranged from amusement to outright abuse.
When I asked about XMRV testing at my last doctor's appointment, my doctor (who is actually a decent guy who is knowledgeable about the disease) said, flippantly, that it was probably a fluke (that was the end of that conversation topic), making a side comment about the questionable quality of the researchers involved in the study (don't shoot the messenger, please).
The impression I got from a recent (rare) news article on CFS was that government disability benefits were not readily available to ME/CFS patients. With respect to health insurance, this country offers universal public health insurance so everyone has access to medical treatment; moreover, medical costs are a fraction of what they are in the States. But this isn't so relevant for CFS patients who "only" have CFS anyway, because the treatment - CBT/GET and vitamins - do not cost much, with or without insurance. It is up to the patient if she wants to try to see specialists for co-morbid conditions (though such specialists will not have heard of ME/CFS).
There are no equivalents of a CAA or a WPI or a CFSAC. There are no online forums like this one (there are some isolated blogs that reflect the lack of resources for information for patients).
This, in the country that shall not be mentioned by name in association with my username (thanks), which has the second (or third) largest economy in the world.
