Which African countries will grow as medical tourism destinations?

With new investment and focus on healthcare systems on the continent, in the longer term, will Africans choose to stay within their country or go to neighbouring countries rather than travel further afield? Ian Youngman predicts the parts of Africa which will grow as medical tourism destinations.

Africa is projected to recover in 2021 from its worst economic recession in half a century.

Home to more than 1 billion people, half of whom will be under 25 years old by 2050, Africa is a diverse continent offering human and natural resources that have the potential to yield inclusive growth and eradicate poverty in the region, enabling Africans across the continent to live healthier and more prosperous lives. With the world’s largest free trade area, the continent is creating an entirely new development path, harnessing the potential of its resources and people.

African countries have managed to keep the COVID-19 virus under control with relatively low number of cases, although the pandemic continues to take a toll on African lives and economies. The region is predicted to rebound in 2021, however growth will vary across countries.

Most countries in Africa now have a rising professional and high-net-worth class, developing just as the Gulf did a decade ago. The growth of Casablanca Finance City, the biggest finance centre in Africa, is just one testament to this.

An inflow of Chinese money has meant healthcare and infrastructure is growing across Africa, and new minerals extraction has brought a surge of income to some countries.

Medical tourism within Africa: set to increase?

Conventional wisdom has seen Africa as a growth source market for medical travellers, which has particularly been targeted by Gulf and Asian countries. Many African politicians have also gone at state expense, to the UK or USA, for even simple medical treatment.

In the short term, just like China now and the Gulf in the past, there is likely to be a small boom in outbound international medical tourism, where Africans choose to go to Asia, the Gulf, Europe or other African countries.

This will probably then fade as more medical tourism remains within Africa. As Africans get richer, medical tourism will change from needs-based to choice-based for the middle classes, while the poor remain driven by need and what free care is available where,

The potential for medical travel in Africa is often confused. Often, whenever certain countries open a new hospital, headlines declare “X hospital will make country Y a medical tourism destination”. Mostly this is untrue, as unless the hospital is properly funded, it will struggle to help locals, let alone people from across the country or from other countries.

Covid-19 has however taught many African countries that they need to speed up their local healthcare provision. Several countries have opened hospitals that offer care to locals, people from across the country and also across international borders.

Africa medical travel: country profiles

A handful of countries that have traditionally been seen as sources, have or plan to promote inbound medical tourism, finding patients mostly from within Africa.

Angola, Botswana, Burundi, Congo, Eswatini, Ethiopia, Guyana, Lesotho, Mali, Uganda, Zambia and Zimbabwe will continue to be a source of outbound medical tourism and a target for other African countries.

Algeria

Plans to become a small destination for spas, cosmetic surgery and dentistry.

Ghana

At the early stages of development of medical tourism, where services are provided mainly to neighbouring countries.

Ivory Coast

Sees medical tourism as a potential income earner. The new tourism strategy 2025 includes promoting health tourism. The plan is to make the country the fifth biggest tourism destination in Africa and the government wants its largest city Abidjan to be a regional hub for accessible and quality healthcare.

Kenya

Is developing a strategy to help reduce medical outbound tourism. The framework aims at positioning Kenya as a destination for specialised healthcare services appealing to both Kenyan and international clients to stem the rising tide of outward medical tourism.

Morocco

Plans to build 30 new hospitals, including five university hospitals in Tangier, Agadir, Rabat, Laâyoune and Beni Mellal. Regulatory reforms have opened the healthcare sector to greater private investment. Individuals who are not doctors (both local and international) have the right to own a clinic or private hospital, but have it run by a healthcare professional. This expansion will encourage medical tourism as Sub-Saharan countries consider Morocco as a healthcare centre, and Europe sees Morocco as a low-cost provider. Most foreign patients in Morocco are of African origin.

Nigeria

Despite many promises, Nigeria, which is not a poor country, has not spent enough federal or state money to keep up with the increased demand for healthcare. Often new hospitals are launched with claims ‘this will end outbound medical tourism’, but then are so starved of operating cash that some have been closed or operate way below capacity.

Medical tourism from Nigeria is the result of the refusal of successive governments to revamp healthcare delivery in the country. Many Nigerians are driven to seek treatment abroad due to lack of trust in local hospitals and medical personnel.

Despite widespread reporting of the plans by Nigeria to curb outbound medical tourism by introducing full universal healthcare and building more hospitals, from 2015 to 2020 attempts to bring in universal healthcare have failed.

Rwanda

Only limited medical facilities are available and for specialist care people have to go to Kenya or South Africa. But it is making major efforts to stand out as a high-end destination in Africa. There has been a lot of promotion of tourism and investment.

South Africa

The Departments of Health and Tourism obstruct the development of medical tourism in South Africa. Both have taken a neutral stance, intentionally not promoting or endorsing it, and highlighting the potential challenges medical tourism could bring to the South African health system. The challenges they list include a widening of disparities due to unequal distribution of health care, unintended subsidisation for healthcare costs for foreign patients, the potential redirection of resources from priority local medical needs to that of foreign patients, and the risk of medico-legal litigation for failed treatment or post-treatment complications.

Many hospitals and doctors in South Africa are also not interested in promoting medical tourism simply due to a shortage of medical practitioners.

The ‘surgery and safari’ model of medical tourism is out of date, and very few agencies have survived or prospered. The massive change to the local healthcare system from universal health insurance over the next decade will also leave little or no room for medical tourism, except in private clinics.

But local politics and agreements with nearby countries on treating the poor with cross-border care means that South Africa will be the African giant with large numbers but low income as much state care is free for cross-border patients.

Tanzania

Since 2015 the Ministry of Health has transformed the health sector. Investment in specialised services has reduced the number of patients seeking medical treatment abroad. The Ministry of Health used to refer 200 to 300 patients abroad annually but this number has dropped to less than 60. The number of individuals paying for treatment abroad now is believed to be small.

Over five years, significant investments have enhanced the availability of specialised services transforming Tanzania into a minor destination for medical tourism.

Tunisia

Sees health tourism as a promising niche market able to boost Tunisia’s economy. The Tunisian government is building a US$50 billion-dollar Tunisia Economic City, a mega-project devoted to building hospitals, clinics, research institutions and other health and wellness facilities.

Tunisia has a massive tourism budget and that includes promoting luxury spa and Thalasso tourism, particularly targeting European seniors. It would only a small step to again promote cosmetic surgery, dental work and simple surgery, for which the country was well known several years ago. It could quickly become a leading destination for European and African medical tourists.