International Journal of Innovation and Economic Development
ISSN 1849-7020 (Print) | ISSN 1849-7551 (Online)
Volume 2, Issue 11, June 2025, Pages 7-22
Health tourism in the Global South: Towards effective policy responses to emerging opportunities and challenges
DOI: 10.18775/ijied.1849-7551-7020.2015.112.2001
URL:https://doi.org/10.18775/ijied.1849-7551-7020.2015.112.2001
1*Asa Romeo Asa, 2Johanna Pangeiko Nautwima
1,2 Namibian-German Institute for Logistics, Namibia University of Science and Technology, Windhoek 13388, Namibia
Abstarct: Health tourism in the Global South has emerged as both an economic opportunity and a policy challenge, reshaping debates around development, healthcare governance, and global mobility. This study analyzes the evolving landscape of health tourism in the Global South, examining its intersection with economic diversification, global mobility, and healthcare governance in emerging economies. Drawing on health systems theory, globalization, and development economics, our synthesis of recent peer-reviewed studies (2020–2025) identifies the primary drivers and structural tensions of the sector. Key drivers, including cost advantages, infrastructural upgrades, supportive policy environments, and rich cultural assets, collectively position Global South countries as competitive destinations. While these benefits have spurred job creation and regional economic growth, this review concurrently highlights significant structural challenges, including internal brain drain, health system inequities, the crowding-out of local patients, and regulatory deficiencies in patient protection. National policy responses vary widely, from India’s proactive marketing to nascent regional efforts in Africa to address the issue. Furthermore, the Covid-19 pandemic intensified interest in wellness-focused preventive models and digital innovations, signaling new evolutionary pathways. We conclude that while health tourism presents major development opportunities, its expansion should be balanced with safeguards to ensure equitable access, a sustainable workforce and systemic resilience. This calls for integrated national strategies, cross-border policy harmonization, and future research on emerging trends such as telemedicine. Overall, this study contributes a critical framework for leveraging health tourism for inclusive and sustainable development in the post-pandemic era.
Keywords: Health tourism, Global South, Economic diversification, Healthcare governance, Medical tourism, Wellness tourism, Sustainable development
1. Introduction
Health tourism is broadly defined as travel undertaken to enhance one’s health and well-being, encompassing both medical and wellness tourism. Medical tourism typically refers to patients traveling for curative or remedial medical treatments, whereas wellness tourism involves travel for preventive therapies, relaxation, and holistic well-being (Jiang et al., 2022; Roman et al., 2023). In essence, health tourism serves as an umbrella concept that includes all resources related to health, from clinical procedures to spa retreats, making it a broader category that fully subsumes medical tourism (Padilla-Meléndez & Del-Águila-Obra, 2016). Recent literature emphasizes that this sector combines aspects of active leisure, disease prevention and medical treatment (Dunets et al., 2020; Roman et al., 2023). Consequently, health tourism spans a continuum of services from wellness-oriented activities (e.g. yoga programs, thermal spas) to invasive medical interventions (e.g. surgeries), all aimed at improving physical or mental health (Erkanli et al., 2024). This inclusive definition is adopted in the present review to clarify that both wellness and medical tourism are integral to health tourism.
Health tourism has gained significant importance in the context of globalization and has emerged as a dynamic and rapidly growing international industry. The rising globalization of healthcare, supplemented by lower transportation costs and digital access to information, has enabled patients to seek health services across borders, effectively making medical tourism an expanding global phenomenon (Zhong et al., 2021). Key drivers include high healthcare costs and long wait times in some high-income countries, which push patients from the Global North (e.g. the US, Canada, and Europe) to travel for affordable, timely care in the Global South (Hanefeld et al., 2014, 2015). Prior to the Covid-19 pandemic, the health tourism sector was on a robust growth trajectory. For example, the global wellness tourism market was valued at approximately USD 639 billion in 2017 and is growing at 6.5% annually, twice the rate of general tourism (Jiang et al., 2022), indicating a strong demand for travel related to well-being. Likewise, international medical patient flows have been steadily increasing, with global forecasts projecting the medical tourism industry to reach nearly USD 180 billion by the mid-2020s (Erkanli et al., 2024). These trends underscore that health tourism, as a multi-dimensional service sector, had become firmly embedded in global travel patterns and trade in services by the end of the 2010s (Zhong et al., 2021).
However, the Covid-19 pandemic abruptly disrupted this growth and highlighted the sector’s vulnerabilities. Worldwide travel bans and health concerns in 2020 led to a sudden collapse of international tourism, and border closures and the suspension of elective treatments severely impacted health tourism (Erkanli et al., 2024). Patient mobility dropped sharply as countries closed their borders, causing a dramatic decline in cross-border medical visits and wellness travel (Yang et al., 2020). Industry reports and academic analyses note that the pandemic’s impact was unprecedented, leading to revenue losses, clinic and spa closures, and job insecurity in many popular medical tourism destinations (Permatasari & Mahyuni, 2022; Toubes et al., 2021). Simultaneously, the crisis forced health tourism providers to innovate and restructure their services to ensure safety and resilience (Jamin et al., 2020). As global travel cautiously resumed in 2021–2022, the health tourism sector began to rebound with a renewed emphasis on wellness, preventive healthcare, and sustainable practices (Erkanli et al., 2024). Current trends suggest that health tourism is poised to regain and even exceed its pre-pandemic momentum, driven by pent-up demand for medical services and an intensified public focus on personal health and well-being in the post-COVID era (Seyfi, 2023). This context of globalization, entwined with a post-pandemic recovery, makes the examination of health tourism especially timely.
Given this background, there is a strong rationale for focusing on the Global South in health tourism studies. The Global South, broadly referring to developing regions in Asia, Africa, the Middle East, and Latin America, plays a dual role in health tourism as a major supplier of services and a source of international patients. Many leading health tourism destinations are in the Global South, benefiting from cost advantages and growing investment in health infrastructure. Countries such as India, Thailand, Malaysia, Turkey, Mexico, and Brazil have become popular medical tourism hubs, attracting thousands of foreign patients annually with competitive pricing and internationally accredited hospitals (Zhong et al., 2021). These destinations actively market procedures such as cardiac surgery, organ transplants, or cosmetic surgery at a fraction of the cost in Western countries, illustrating how globalization has opened opportunities for emerging economies to tap into the lucrative health travel market. Conversely, the Global South also encompasses the home countries of many medical travelers who seek care abroad because of limitations in their domestic health systems. Researchers have observed that historically, much of the literature has centered on flows from developed to developing countries (Salehi-Esfahani et al., 2021), reflecting how patients from wealthier nations travel to lower-cost regions for treatment.
However, equally important are South-South dynamics, where intra-regional medical travel is growing as patients within the Global South cross borders to access better or more specialized care in neighboring countries. A prominent example is Africa, where patients from surrounding Southern African Development Community (SADC) countries routinely travel to hubs such as South Africa or Tunisia for healthcare services that are not readily available at home. North African and Middle Eastern nations are increasingly leveraging their natural and medical resources to attract wellness and medical tourists, offering gorgeous beaches, spas, and natural hot springs, along with modern yet affordable medical facilities (Erkanli et al., 2024). Such evidence highlights the continental African perspective that, while Africa’s share of global health tourism is currently modest, there is growing interest in developing this sector as a driver of economic diversification and healthcare improvement on the continent. Early signs include targeted government initiatives, public-private partnerships to build internationally accredited hospitals, and marketing of Africa’s unique wellness assets (such as safari lodges with wellness retreats and traditional healing therapies). Focusing on the Global South (and Africa in particular) is thus important not only because these regions are pivotal in the present and future landscape of health tourism, but also because they face distinct challenges (e.g. capacity gaps, equity concerns) that merit academic attention in the post-pandemic global health (Seyfi, 2023). This review highlights how globalization and health tourism intersect with development, equity, and local health system impacts in emerging economies by examining global trends through a Global South lens.
In light of the above, this narrative literature review critically examines recent scholarly research (2020–2025) on health tourism in the Global South, with particular emphasis on both medical and wellness tourism dimensions. The purpose of this study is to synthesize current evidence on how globalization and the Covid-19 pandemic have influenced health tourism patterns, opportunities, and challenges in developing regions, and why these regions warrant focused analysis. In a nutshell, this introduction has set the stage by defining the topic, explaining its significance in a globalized and post-Covid world, and justifying the concentration on the Global South, thereby establishing a foundation for the full literature review that follows. The remainder of this review is structured as follows: First, we outline the key concepts and scope of health tourism, clarifying definitions and subcategories as used in the recent literature. Next, we present global trends and post-pandemic developments in medical and wellness tourism, establishing a worldwide context. We then narrow the focus to the Global South, providing a thematic overview of the literature on Asian, Latin American, and African health tourism experiences, including a more detailed discussion on the African continent’s emerging role, drawing on regional case studies and data. Throughout, we highlight pertinent findings on the drivers (such as cost differentials and policy initiatives) and impacts (such as economic gains and public health implications) of health tourism in these contexts, as reported by peer-reviewed studies. Finally, we detail the methodological approaches in the subsequent section, followed by a comprehensive discussion of the findings, and conclude with conclusions and recommendations for future research.
2. Literature Review
2.1. Conceptual Background
Health tourism is broadly defined as travel undertaken for health-related purposes, encompassing curative medical care and preventative wellness activities (Büyüközkan et al., 2021; Manna et al., 2020). In other words, it is an umbrella term that includes medical tourism, which focuses on travel for medical treatment or surgical procedures, and wellness tourism, which focuses on enhancing or maintaining well-being through activities such as spa therapy, fitness retreats, or alternative therapies (Leung & Ku, 2024). Recent literature emphasizes this distinction, underscoring that medical tourism involves invasive interventions or clinical treatments abroad, whereas wellness tourism centers on services such as Ayurveda, thermal baths, meditation, and other holistic health experiences (Leung & Ku, 2024; Pessot et al., 2021). As researchers clearly define these subcategories, they ensure conceptual clarity when examining the growing health tourism industry. Health tourism has expanded rapidly over the past decade, fueled by rising demand for high-quality medical services and wellness experiences beyond one’s home country (Büyüközkan et al., 2021). This study adopts an inclusive definition that health tourism comprises both medical and wellness travel, acknowledging that each segment may have different drivers and implications for the Global South.
2.2. Theoretical Foundation
From a health systems theory perspective, the rise of health tourism raises critical questions about capacity, governance, and resource allocation in destination countries’ healthcare systems. On the one hand, an influx of foreign patients can incentivize investments in hospital capacity and advanced treatments. However, it may strain local resources or divert them toward serving international clients. Scholars caution that an unregulated boom in medical tourism can exacerbate inequities in local health access by intensifying the uneven allocation of resources and increasing the migration of skilled health professionals from public hospitals to private facilities in host countries (Hall, 2011; Johnston et al., 2010). In other words, doctors and capital may shift to profit-oriented clinics for tourists, potentially reducing the availability of services for local populations. Therefore, governance and policy are paramount. For instance, inadequate regulation in countries such as Guatemala has led to gaps in patient safety and equity, highlighting the need for stronger government oversight and accreditation standards in the medical tourism sector (Labonté et al., 2018). Therefore, a health systems approach examines how health tourism is integrated into national health planning, whether through public-private partnerships, accreditation of facilities, or reinvestment of revenues, to ensure that boosting health tourism does not undermine public health care delivery. Thus, effective governance (e.g., licensing, quality control, and standardization) is necessary to mitigate challenges and align health tourism with broader health system goals, such as equity and sustainability (Figueiredo et al., 2024). In summary, this perspective underscores that the capacity and governance of the host health system fundamentally shape the outcomes of health tourism’s growth in the Global South.
Regarding globalization and patient mobility standpoint, the globalization lens views health tourism as an outcome of increasing cross-border mobility of patients and internationalization of health services. Global interconnectedness, with respect to cheaper air travel, digital health information, and marketing of medical services abroad, has made it easier for patients to seek care outside their home country. Key drivers include cost differentials and wait times; for example, patients from high-income countries facing expensive or delayed treatment at home often travel to lower-cost destinations for quicker or more affordable care (Büyüközkan et al., 2021; Figueiredo et al., 2024). Indeed, globalization has effectively turned certain health services into internationally traded commodities, as described by the trade-in-health-services framework (for example, Mode 2 of GATS). In practical terms, developed countries are recognized for providing cutting-edge medical technologies, while patients from various parts of the world seek more affordable treatment options by travelling to developing nations(Supriadi et al., 2024). Thus, a two-way dynamic emerges as affluent nations export patients (and health financing) overseas, while emerging economies import patients by exporting health services. This has been enabled by globally recognized accreditation systems and the marketing of medical expertise, creating trust in care delivered in the Global South (Hassan, 2023).
Health tourism exemplifies how global trade and mobility allow healthcare to transcend borders, linking patient flows to global networks of hospitals and professionals. It highlights themes such as international patient mobility, cross-border telemedicine, and the role of multinational hospital chains, as well as the need for international regulations to manage issues such as quality standards and the spread of infectious diseases in a highly connected world (Labonté et al., 2018). Overall, globalization provides the context in which health tourism has flourished as a form of global service trade, driven by patient choice and mobility.
In the context of developmental economics, the growth of health tourism in the Global South can be examined by focusing on how it contributes to economic diversification and development outcomes. Many developing countries view health tourism as a strategic sector for diversifying their economies beyond traditional industries (such as agriculture or resource extraction) and moving up the value chain in services (Kim & Hyun, 2022; Ratnasari et al., 2022). In doing so, countries can earn export income in the form of medical fees, hospitality services, and related tourism expenditures by attracting foreign patients. Hence, governments are increasingly investing in medical infrastructure and marketing to tap into this multi-billion-dollar global market, seeing it as a way to boost GDP, create skilled jobs, and stimulate related sectors (such as hotels, transport, and wellness products) (Figueiredo et al., 2024). For instance, the United Arab Emirates has deliberately incorporated medical tourism into its broader economic diversification strategies. As part of this effort, the government is collaborating with all health authorities to ensure that both public and private hospitals across the country meet internationally recognized standards of excellence (Hassan, 2023), thereby positioning the country as a regional medical hub. Such initiatives, complemented by partnerships with international healthcare providers, have quickly made cities such as Dubai and Abu Dhabi major destinations for foreign patients seeking high-quality treatment, contributing to the UAE’s goal of a more diversified knowledge-based economy.
The developmental lens therefore highlights the potential for health tourism to spur investment in healthcare infrastructure and human capital (e.g. specialist doctors and nurses), while also cautioning that the local benefits depend on how revenues are distributed and reinvested. Ideally, a thriving health tourism sector can have positive spillovers, such as improving healthcare quality for locals, generating government revenue (through taxes or public-private initiatives) to fund public health, and fostering innovation in the medical services sector. However, economists have also noted the importance of sustainable planning. For example, ensuring that growth in private health tourism does not hollow out the public sector, and that training and capacity-building keep pace so that domestic needs are met alongside tourist demand (Vaidya et al., 2020). From a development economics perspective, health tourism is seen as a double-edged sword, a promising avenue for economic development and diversification in the Global South, contingent on effective governance to maximize benefits for the broader society.
In brief, these theoretical lenses collectively provide a comprehensive understanding of health tourism in the Global South. Health systems theory draws attention to internal system preparedness and equity issues, globalization theory situates health tourism within worldwide flows of patients and services, and developmental economics underscores the macroeconomic stakes and policy choices involved. Together, they form a conceptual framework for analyzing how health tourism can be leveraged for positive outcomes, such as improved health service capacity, economic gains, and global partnerships, while managing the challenges related to governance, equity, and sustainability (Figueiredo et al., 2024; Leung & Ku, 2024). This framework guided the literature review, ensuring that the complex interplay of healthcare, global mobility, and development was critically examined in the context of health tourism.
3. Methodology
This study employs a narrative literature review approach to examine the evolution of health tourism in the Global South, with particular attention to its drivers, benefits, challenges, and governance responses. The objective was to synthesize conceptual perspectives and empirical findings across a diverse set of peer-reviewed journal articles to identify recurring themes, critical gaps, and emerging trends that shape the field of medical and wellness tourism in developing regions. Unlike systematic reviews, which rely on strict protocols, keyword-based screening, and replicable search strategies, the narrative review method offers greater interpretive flexibility than systematic reviews. This is especially useful for exploring complex multidisciplinary topics such as health services, tourism, public health governance, and global mobility. As noted by Snyder (2019), narrative reviews are well-suited for generating integrative insights where the academic field is still emerging or intersects multiple domains. Paré and Kitsiou (2016) further argue that this approach allows scholars to critically engage with theory and context without the constraints of narrow inclusion criteria. Given that health tourism spans disciplines including healthcare management, tourism studies, development economics, and international public health, this method was deemed to be the most appropriate.
This review examined 44 peer-reviewed journal articles published between 2020 and 2025, all sourced from reputable Scopus-indexed journals. The inclusion criteria focused on literature relevant to the four key thematic dimensions of this study: (a) economic and infrastructural drivers of health tourism, (b) opportunities and benefits for host countries, (c) risks and systemic challenges, and (d) policy and governance responses. Articles were selected based on their conceptual contribution, methodological quality, regional focus on the Global South, and relevance to the post-pandemic health tourism discourse. Each article was reviewed in full to enable a comparative synthesis across thematic clusters and geographic contexts, as per Torraco’s (2005) recommendations, thereby ensuring analytical consistency throughout the review process. In line with Greenhalgh et al. (2018), this method balances breadth and depth by enabling theoretical reflection and empirical contextualization. Ultimately, the purpose of this review is not merely to summarize past literature but to integrate existing knowledge into coherent insights that inform future research, policy, and practice in the growing field of health tourism in the Global South. Table 1 presents the key reviewed articles based on the four themes.
Table 1: Key reviewed articles
| Authors and Year | Key Findings |
| Baiev et al. (2020) | Low treatment costs in Global South countries offer substantial savings and attract international health tourists. |
| Pailwar & Mitra (2025) | Moderate cost differences due to currency exchange have a significant influence on inbound medical travel to India. |
| Gholipour & Esfandiar (2024) | Investment in modern infrastructure and technology enhances international patient trust and drives sector growth. |
| Latief & Ulfa (2024) | Well-equipped and resourced facilities significantly increase a destination’s appeal to foreign patients. |
| Virani et al. (2020) | Government support through streamlined visas and marketing promotes medical tourism but requires safeguards. |
| Wiyati et al. (2025) | Fiscal incentives and international healthcare partnerships are key enablers of health tourism in the Global South. |
| Bhuyan et al. (2025) | Cultural wellness traditions like Ayurveda and Thai massage attract holistic health tourists seeking authentic care. |
| Mangwane & Ntanjana (2020) | South Africa’s cultural and natural assets provide a competitive edge in developing wellness tourism. |
| Shirisa & Kumari (2023) | Medical tourism enhances foreign exchange earnings, employment, and economic diversification in host countries. |
| Islam et al. (2025) | Increased demand from foreign patients drives infrastructure upgrades and improved services in Malaysia. |
| Shenkar et al. (2021) | Advanced hospitals in countries like India and Turkey raise domestic care standards and facilitate knowledge transfer. |
| Samsudin et al. (2024a) | Medical tourism contributes to internal brain drain, with professionals shifting from public to private sectors. |
| Samsudin et al. (2024b) | Urban hospitals draw talent away from rural areas, worsening health inequalities in destination countries. |
| Akhavan et al. (2023) | Medical tourism reinforces a dual-tier health system, disadvantaging poor and rural communities. |
| Kanda et al. (2020) | Influx of medical tourists can overwhelm private hospitals and shift focus from local patient care. |
| Md Zain et al. (2022) | Prioritisation of foreign patients inflates costs and extends wait times for domestic populations. |
| Mishra & Sharma (2021) | India actively promotes itself as a health tourism hub through marketing and visa facilitation. |
| Ilo et al. (2023) | South Africa leads Sub-Saharan Africa in medical tourism but lacks a coordinated national strategy. |
| Maurette & Fguira (2022) | Tunisia serves regional patients through private clinics, largely outside mainstream tourism models. |
| Jalali et al. (2025) | Regional bodies like SADC and ECOWAS are exploring harmonised standards but lack comprehensive strategies. |
| Yeates & Surender (2021) | Structural disparities and weak coordination hinder regional health integration in many African regions. |
| Alshamsi (2024) | The UAE mandated global hospital accreditation to enhance patient safety and international appeal. |
| Bostani et al. (2024) | Weak malpractice protections and lack of insurance undermine trust in medical tourism systems. |
Source: Authors’ construction (2025)
4. Results
4.1 Drivers of Health Tourism in the Global South
Health tourism in the Global South is gaining momentum due to a combination of economic, infrastructure, policy, and cultural factors. These drivers not only shape the competitive advantages of emerging destinations but also respond to the growing global demand for affordable, high-quality, and culturally enriched medical and wellness experiences. The subsections below examine the key enablers that collectively position Global South as an increasingly attractive hub for international health travelers.
- Economic drivers
Cost advantages and favorable currency exchange rates are consistently highlighted as key motivators of health tourism in the Global South. Lower treatment prices relative to developed countries, sometimes offering “first-world” care at “third-world” prices, enable significant savings for patients (Baiev et al., 2020). A recent study in India found that exchange-rate-adjusted price differences have a significant (though nonlinear) impact on inbound medical travel, suggesting that moderate cost gaps most effectively attract foreign patients (Pailwar & Mitra, 2025). Overall, affordability and currency arbitrage create a strong pull factor, as patients seek high-quality services at a fraction of the cost of those available in their home countries (Baiev et al., 2020).
2. Infrastructure and technology
Improvements in healthcare infrastructure and the adoption of advanced medical technology across emerging economies have greatly enhanced their appeal to international patients. Many destination countries have invested in modern hospitals and equipment to meet international standards, often achieving accreditation and higher service quality (Gholipour & Esfandiar, 2024). This build-up of capacity increases trust while allowing providers to offer complex procedures with cutting-edge techniques (e.g., robotic surgery, telemedicine integration) comparable to those in the Global North. Bibliometric evidence indicates that well-equipped facilities with adequate resources, qualified personnel, and advanced medical technology significantly boost a location’s attractiveness to foreign patients (Latief & Ulfa, 2024). The growth of medical tourism itself spurs further investment in infrastructure and the adoption of new technologies, as providers strive to satisfy discerning international clients.
3. Policy incentives and partnerships
Proactive government policies and cross-border collaborations drive health tourism expansion. Many governments in the Global South have adopted supportive measures, such as streamlined medical visas and targeted marketing campaigns, to entice overseas patients (Virani et al., 2020). Some offer fiscal incentives; for example, Malaysia provides 100% tax exemptions on qualifying capital investments in medical tourism facilities to encourage private sector growth and foreign investment in the health tourism industry (Wiyati et al., 2025). International partnerships and agreements further facilitate medical travel, as this sector inherently fosters international collaboration in healthcare (Wiyati et al., 2025). Such collaborations range from bilateral patient referral agreements to joint ventures in hospital management, all of which help to integrate and strengthen transnational healthcare networks. As governments align policy frameworks with these opportunities, they leverage health tourism for economic gain and diplomatic goodwill.
4. Cultural and natural assets
Global South destinations also capitalize on their unique cultural heritage and natural endowments to attract wellness-oriented travelers to their countries. Many countries offer traditional healing systems and wellness practices, such as India’s Ayurvedic medicine, yoga retreats, or Thai massage, as authentic experiences that appeal to health tourists seeking holistic care in an exotic setting (Bhuyan et al., 2025). Similarly, natural attractions such as tropical climates, scenic landscapes, and thermal springs provide therapeutic environments that complement medical services. South Africa’s rich cultural and natural landscape has been identified as an excellent asset for developing wellness tourism, providing the country with a competitive edge in this niche (Asa et al., 2022; Mangwane & Ntanjana, 2020). These cultural and environmental resources play a dual role in enhancing therapeutic offerings and enabling destinations to market a more compelling wellness tourism experience, blending medical treatment with leisure, spirituality, and nature-based healing (Virani et al., 2020). Economic, infrastructural, policy-driven, and cultural/natural drivers intertwine to position Global South destinations as growing hubs in the health and wellness tourism industry.
4.2 Opportunities and Benefits
Health tourism has emerged as a catalyst for economic diversification in many countries in the Global South. This niche tourism injects new revenue and creates jobs across various skill levels, attracting foreign patients. For example, a panel study of 49 economies found that higher medical tourism inflows significantly promote growth in the domestic healthcare sector (Gholipour & Esfandiar, 2024), while case evidence from India shows that inbound medical travelers contribute to foreign exchange earnings and substantial employment opportunities, boosting overall economic output (Shirisa & Kumari, 2023). These inflows spur broad development, with governments and investors channeling funds into expanding hospitals, clinics, and related infrastructure to meet international patient demand. In Malaysia, for instance, the surge in overseas patients has led to new private hospitals, upgraded medical facilities, and improved transport and lodging options for health tourists (Islam et al., 2025). Such infrastructure investments enhance the medical tourism experience and benefit local communities through better health services and ancillary improvements in transit and accommodation facilities. The result is a more diversified economy beyond traditional sectors, fueled by a growing health tourism value chain and its multiplier effects on employment and income (Shirisa & Kumari, 2023).
Beyond direct economic gains, health tourism drives technology and knowledge transfer and stimulates ancillary sectors in the host countries. To attract discerning international patients, local providers have adopted cutting-edge medical technologies and best global practices. Countries such as Turkey and India have established state-of-the-art hospitals with advanced equipment and internationally accredited standards, elevating the skills of local health professionals and the quality of care available domestically (Shenkar et al., 2021; Shirisa & Kumari, 2023). Researchers have noted that this trend fosters international collaboration and the exchange of medical expertise, ultimately strengthening health systems in the Global South (Wiyati et al., 2025). Simultaneously, a thriving medical tourism industry energizes supporting sectors such as hospitality, transportation, and tourism services. Foreign patients (often accompanied by family) generate demand for hotels, restaurants, travel agencies, and translators, creating a ripple effect of business growth and new jobs beyond hospitals (Shirisa & Kumari, 2023). These interlinked benefits, from higher-tech healthcare to robust ancillary markets, underscore the multifaceted development opportunities that health tourism presents for developing economies. Each element reinforces the others, contributing to sustainable economic diversification and improved livelihoods in the host communities.
4.3 Risks and Challenges
While health tourism offers significant opportunities for economic growth and advancement, it also presents a range of structural and ethical challenges for host countries in the Global South. These risks and challenges stem primarily from the reallocation of healthcare resources toward more profitable international patients, often at the expense of local populations. The following subsections examine how health tourism can deepen inequalities, strain domestic healthcare systems, and undermine the sustainability and equity of healthcare.
- Brain drains and inequity
The rise of health tourism in many Global South countries has drawn health professionals out of public service and into lucrative private facilities catering to foreign patients. This internal brain drain sees specialists migrating from understaffed public hospitals to urban private clinics in response to high-paying international demands (Samsudin et al., 2024a). As a result, local health systems face worsened workforce maldistribution, where rural and public sectors are left under-resourced, while advanced care concentrates in tourist-oriented hospitals (Samsudin et al., 2024b). Such shifts exacerbate existing health inequities as impoverished and remote communities lose access to experienced providers. Analysts warn that medical tourism often precipitates an internal exodus of medical personnel and reduces services for the poor, reinforcing a two-tier health system in destination countries (Akhavan et al., 2023).
2. Strain on private systems
The booming medical tourism industry can also strain the private healthcare systems of host nations. In some cases, an influx of foreign patients has overcrowded private hospitals and diverted clinical resources towards profitable elective procedures for visitors (Kanda et al., 2020). This can come at the expense of local needs, as private providers tend to prioritize international clients who pay premium prices, potentially inflating costs and wait times for domestic patients (Md Zain et al., 2022). Communities may grow frustrated as healthcare becomes less affordable and accessible to locals when facilities focus on serving medical tourists. Over time, these dynamics have deepened the divide between private and public care, burdening public hospitals with the bulk of low-income patients, while private institutions serve predominantly wealthier locals and foreigners (Akhavan et al., 2023). The result is an entrenched dual healthcare system where health tourism’s gains are offset by internal brain drain and widening inequity in access and quality of care.
4.4 Policy and Governance Responses
In many Global South countries, governments have developed strategies to leverage health tourism for economic growth. Mishra and Sharma (2021) note that the Indian government actively markets itself as a premier medical travel hub and has eased visa policies for foreign patients. South Africa likewise sees medical tourism’s potential and was Sub-Saharan Africa’s leading destination prior to the pandemic, although its approach remains less coordinated (Ilo et al., 2023). Tunisia leverages a strong public health foundation and private clinics to serve neighboring Libyan and other African patients, with health travel evolving outside traditional mass tourism channels (Maurette & Fguira, 2022). At the regional level, blocs like SADC and Economic Community of West African States (ECOWAS) are considering cooperative frameworks and harmonized standards for health tourism. Although comprehensive regional strategies remain nascent, experts call for integrated planning and shared regulations to build regional medical tourism industries (Jalali et al., 2025). However, marked disparities persist, with some African regions having minimal coordinated health policies, and resource or political barriers hindering deeper health integration (Yeates & Surender, 2021).
Ensuring quality and patient protection is a critical governance challenge as health tourism expands in India. Many destinations have embraced international accreditation to signal their quality. Alshamsi (2024) explained that the UAE mandated global hospital accreditation to ensure patient safety and enhance its appeal to foreign patients. However, regulatory gaps remain. For instance, weak malpractice laws and limited insurance for medical tourists can undermine trust and affect outcomes (Bostani et al., 2024). Virani et al. (2020) caution that medical tourism can spur investment and innovation but may divert resources from local patients and deepen inequities at the expense of marginalized groups if left unchecked. Malaysia’s post-pandemic experience underscores the importance of safeguarding equitable access for domestic patients, even as the country reopens to international medical travelers (Samsudin et al., 2024b). Therefore, policymakers must balance industry growth with health equity goals.
4.5 Conceptual framework
The conceptual framework illustrates how health tourism development in the Global South is shaped by the interplay of drivers, mediators, and moderators. Economic drivers, particularly affordability and favorable exchange rates, serve as strong pull factors for international patients seeking high-quality care at reduced costs (Baiev et al., 2020; Nautwima & Asa, 2021; Pailwar & Mitra, 2025). Infrastructure and technology further reinforce this appeal, as investments in modern hospitals, accreditation, and advanced medical procedures enhance service quality and trust (Gholipour & Esfandiar, 2024; Latief & Ulfa, 2024). Policy incentives and partnerships, including streamlined visas, tax exemptions, and bilateral agreements, strengthen transnational healthcare networks and expand market access (Virani et al., 2020; Wiyati et al., 2025), while cultural and natural assets such as traditional healing practices and wellness-oriented environments provide distinctive competitive advantages (Bhuyan et al., 2025; Mangwane & Ntanjana, 2020). These drivers collectively lead to health tourism development, manifested through economic diversification, foreign exchange earnings, employment creation, and systemic healthcare improvements (Shirisa & Kumari, 2023; Islam et al., 2025). The relationship is moderated by strategic positioning and quality assurance measures, which safeguard competitiveness and patient trust (Mishra & Sharma, 2021; Alshamsi, 2024), and mediated by equity safeguards and regional cooperation that ensure inclusive and sustainable growth (Samsudin et al., 2024b; Jalali et al., 2025).
Figure 1: Conceptual framework
Source: Authors’ work (2025)
5. Discussion and Synthesis
This review revealed several cross-cutting themes and tensions that characterize the development of health tourism in the Global South. The foremost is the inherent trade-off between economic opportunity and equity. Health tourism serves as a strategic lever for economic diversification, employment creation, and infrastructure development (Shirisa & Kumari, 2023; Gholipour & Esfandiar, 2024). However, the growth of this sector exacerbates internal health inequities, including the migration of medical professionals from the public to the private sector and the over-concentration of health investments in urban centers (Samsudin et al., 2024a; Akhavan et al., 2023). These tensions underscore structural dualism, where the pursuit of global competitiveness risks marginalizing underserved populations within host countries.
The second theme is the uneven policy and governance responses to these tensions. While countries such as India, Tunisia, and Malaysia have implemented ambitious national strategies and accreditation systems (Mishra & Sharma, 2021; Alshamsi, 2024), regional coordination remains fragmented (Jalali et al., 2025; Yeates & Surender, 2021). Disparities in legal protections, malpractice coverage, and quality standards persist, reinforcing a global governance gap that can affect patient safety and system integrity (Bostani et al., 2024). As such, the need for harmonized regulatory frameworks and cross-border cooperation, especially within regional economic blocs like SADC and ECOWAS, has become increasingly urgent.
Despite these challenges, emerging trends suggest new directions for inclusive and sustainable health-tourism. Post-pandemic shifts have reignited interest in preventive and wellness-focused models that integrate nature, culture and technology (Erkanli et al., 2024; Bhuyan et al., 2025). The digitalization of services, including telemedicine and hybrid care models, is also redefining patient expectations and expanding access across geographical boundaries (Latief & Ulfa, 2024). Moreover, innovations such as wellness technology and digital nomad health packages reflect the growing convergence of tourism, lifestyle, and healthcare, offering promising entry points for the Global South to differentiate itself in the global market. Overall, this synthesis highlights that while health tourism can serve as a pathway for development, realizing its benefits without compromising equity and sustainability requires deliberate governance, adaptive policies, and inclusive planning that centers on both local needs and global trends.
6. Conclusion and Recommendations
This narrative review explored the evolving landscape of health tourism in the Global South, encompassing both medical and wellness tourism. The findings reveal that health tourism is a rapidly growing global industry and a critical vector for economic development, infrastructural advancement, and cross-border collaboration in developing regions. The review highlights four key drivers–cost competitiveness, investment in infrastructure and technology, enabling policies, and unique cultural/natural assets–that have positioned the Global South as an increasingly attractive destination for international patients (Pailwar & Mitra, 2025; Bhuyan et al., 2025). These benefits are reinforced by evidence of economic diversification, job creation, knowledge transfer, and stimulation of ancillary sectors such as hospitality and transport (Shirisa & Kumari, 2023).
However, this review also identified structural risks and challenges. Among these are internal brain drain, widened health inequities, strain on domestic private healthcare systems and regulatory weaknesses. Without careful governance, the pursuit of global competitiveness in health tourism can lead to a dual-tiered health system that disproportionately benefits foreign patients while compromising access and quality for domestic populations (Akhavan et al., 2023). Policy responses vary across contexts, with some countries showing strong national strategies and accreditation frameworks, while others lack regional coherence and robust protection for patients and health workers. Based on these findings, the policy implications include the urgent need for integrated health tourism strategies that align economic goals with public health mandates. Governments should invest in equitable workforce distribution, enforce international accreditation standards, and incentivize the reinvestment of tourism revenues into public health systems. Furthermore, regional bodies such as SADC and ECOWAS should accelerate efforts to harmonize legal and quality standards for cross-border care.
Finally, future research should explore the long-term social and economic impacts of digital health technologies, the role of wellness tourism in post-pandemic recovery, and governance of emerging models such as digital nomad healthcare. Comparative studies across regions could further illuminate the best practices for inclusive and sustainable health tourism in the Global South.
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