Analysis in brief: Drawn by lower costs and high-quality healthcare offered by Africa’s private clinics, medical tourists from abroad are bringing hard currency appreciated by governments, as well as driving private sector investment into state of the art medical care. Against the danger of creating a two-tier medical care system, advocates of medical tourism say the public healthcare system will benefit from the availability of new healthcare expertise.
Medical tourism is defined by the World Health Organization as travel to a foreign country for non-essential procedures, such as cosmetic surgery, while medical travel is defined as what is done for essential healthcare for procedures unavailable in the patient’s home country. However, both these categories are generally combined into one, following the US Centre for Disease Control and Prevention’s definition of medical tourism as simply travelling to another country for medical care. Because incoming foreigners are issued temporary tourist visas, they are listed as tourists by the host countries. Tunisia’s government notes that patients arriving for medical care take excursions outside their healthcare facilities and are usually accompanied by travel companions who enjoy activities associated with holidays. African healthcare providers and hospitals seeking medical tourists advertise patients’ trips as actual tourism opportunities, and they partner with tourism companies to provide cultural and recreational experiences.
Globally, medical tourism is projected to grow at an annual rate of 12% from 2023 to 2032, with revenues increasing from US$115.6 billion in 2022 to an estimated US$346 billion by 2032. The African Development Bank reports that Africans spend more than US$1 billion a year on medical services in other continents because of the superiority of overseas facilities and the availability of specialists. Africa’s desire to localise such business is shared by governments and the private sector, which is driving investment in medical facilities, from building state-of-the-art structures to training and, importantly, retaining skilled medical personnel and specialists. The development of private hospitals built to capture medical tourism business may solve the talent flight of African doctors and nurses to Europe, which has been detrimental to African healthcare. Despite costly investment in African private healthcare facilities aimed at medical tourism, these still offer the lowest prices to patients in the world, and the world is noticing.
Image courtesy: JacobOcenFay/Wikimedia
Regional hubs draw medical tourists to Africa
North Africa has been the continental leader in the attraction of overseas medical tourists. In Sub-Saharan Africa, Nigeria has positioned itself as West Africa’s healthcare hub, while Kenya claims the title for East Africa. Central Africa has no medical tourism industry, while Southern Africa’s medical tourism is dominated by South Africa.
A pioneer in medical tourism from the 1960s when the first heart transplant was performed there, South Africa leads the continent in number of foreign patients treated and revenue earned. Complicated procedures like open heart surgery are available at a fraction of the cost of such procedures in Europe and the US. Affordability lures foreign patients for cosmetic surgeries like breast augmentation, liposuction, nose reshaping and facelifts. Medical tourism gravitates to Cape Town in particular to take advantage of the city’s natural and cultural attractions.
Tunisia is North Africa’s medical tourism leader. While South Africa draws much of its medical tourism from other Southern African nations, Tunisia draws most of its 500,000 annual foreign hospital patients from Europe. Another two million patients receive same-day care in Tunisia. Like South Africa, Tunisia offers affordable quality medical care with cultural and recreational attractions outside hospitals. Although cosmetic surgery is a primary attraction, Tunisia specialises in fertility treatments and is the world’s second-largest provider of thalassotherapy (a skin treatment procedure). The Tunisian treatment is unique in that its therapy employs minerals harvested from its Mediterranean shore. For millennia, Tunisia’s Mediterranean seawater has proved beneficial in the treatment of skin diseases.
However, other than Libya, all Northern African countries have thriving medical tourism industries. Egypt advertises the quality of its doctors alongside the holiday experience of its antiquities. Morocco promotes its expert but affordable dental treatments side by side with spectacular scenic and cultural attractions. State-of-the-art advanced diagnostic services are offered at Mohammed VI University International Hospital, as well as robotic surgery. Additionally, Algeria uses the low cost of its quality healthcare to draw patients from the Sahel region of Africa.
The Sahel’s western boundary is Nigeria, West Africa’s medical tourism hub. The country earns more than US$1.1 billion from medical tourism, although the patients of private hospitals that attract foreigners also draw Nigeria’s affluent elites. This generates roughly the same amount of revenue that Tunisia earns. Ghana has entered the market with the creation of the Africa Medical Tourism Council, which it has used to sign agreements with other African countries to offer treatments at Ghanaian facilities to their citizens.
As East Africa’s medical tourism leader, Kenya has built its industry on regional patients. Other African countries send 5,000 patients each year for treatment in Kenya. However, in recent years, investment in private hospitals aimed at foreign medical tourism has drawn patients who would have gone to North Africa or the Middle East, including the United Arab Emirates that dominates that area’s medical tourism. The reason for Kenya’s success is the marketing of its African wildlife and cultural experiences, particularly big game safaris and the Maasai people.
Ethiopia has attracted US investors in its ambition to boost medical tourism in East Africa. A new US$ 400 million hospital, the Roha Medical Campus, is being built near Addis Ababa’s Bole International Airport, which is East Africa’s air transportation hub. Ethiopia is also advertising its cultural and natural attractions as part of the experience.
Data courtesy: Investment Monitor
Addressing the danger of a two-tier healthcare system
While no one opposes Ethiopia’s grand new private hospital, the complex offers a stark contrast with the public healthcare system that is struggling in all parts of the country other than war-torn areas, where it has collapsed. The contrast exists in all African countries where modern, well-staffed private hospitals offer quality care to foreigners, while the public healthcare sector must cope with understaffed, antiquated facilities. Noting that Africans spend US$1 billion annually travelling outside the continent for medical treatment, builders of the new Ethiopia hospital say they have located their facility near the airport precisely to lure medical travellers, to capture them so they need not go to the United Arab Emirates or India. The immediate aim is to convince Africans to seek their medical tourism within the country. Moreover, investors in medical tourism argue that the private hospitals designed for their industry will be available for specialised care for ordinary Africans who would otherwise be flown to Europe for life-saving procedures by charitable organisations.
Beyond that, they argue, localising high calibre medical talent in private hospitals boosts any nation’s healthcare system by having a pool of skilled professionals available for teaching and skills sharing. Because ordinary citizens access private hospitals through health insurance, the medical tourism industry seeks expansion of health insurance throughout Africa. Medical aid schemes co-financed by governments will pay for emergency procedures required by the poor. Africa’s for-profit medical tourism industry is also considering other innovations to expand quality healthcare, aware that a two-tier medical system cannot be tolerated.
The critical points:
- Medical tourism is a growing and lucrative industry in Africa, dominated by North Africa and three regional hubs: Kenya, Nigeria and South Africa
- Africa’s modern hospitals designed for medical tourism provide expert care while offering tourism access to unique African natural and cultural attractions
- Conscious of the need to equalise a two-tier healthcare system, Africa’s private hospitals are offering access to indigent patients, advocating for the expansion of health insurance and raising their country’s medical standards through trained staff and specialised equipment