In reply to a question in Parliament, Shri Ghulam Nabi Azad, Union Minister for Health and Family, released some previously unpublished figures and stated that no later figures are yet available.
Total number of overseas visitors
2009 5,167,699 2010 5,775,6922011 6,309,222
Total number of overseas visitors who came for medical treatment
2009 113,6892010 155,9442011 138,803
These government figures put medical tourist arrivals at around 2% of total overseas visitors.

With many of the 50 countries that had already advised citizens to think twice before traveling to Thailand, upgrading advice to recommend that they either do not travel there at all or not to travel anywhere in or near the capital of Bangkok, medical tourism in Thailand is suffering as people cancel travel plans.
Kuwait has recommended its citizens in Thailand to return home, and the UAE advised all to delay their planned travel to Thailand, while Oman has advised all to avoid Bangkok. This could affect Thailand’s medical tourism industry, as it is the period when people from the Middle East seek annual checkups at Thai hospitals.
The Thai Government has imposed a 60-day state of emergency, which gives security forces the power to impose curfews, detain suspects without charge, censor media, ban political gatherings of more than five people and declare areas off-limits.
The political situation in Thailand is unpredictable and sometimes volatile. Over recent years there have been instances of civil and political unrest resulting in large demonstrations and in some cases violence.
The state of emergency applies to Bangkok and the neighbouring provinces of Nonthaburi, Pathum Thani and Samut Prakarn, and includes the Suvarnabhumi International Airport, one of the busiest in Asia.
The Thai government has so far imposed no travel restrictions but this may change.
Political demonstrations continue in and around Bangkok and elsewhere in Thailand. Some of these have been violent, including the use of firearms, and there have been casualties and deaths. The situation is unpredictable and further protests are expected.
800,000 Brits travel to Thailand every year and the Foreign and Commonwealth Office (FCO) advises against all but essential travel to Bangkok and neighboring areas and for most of the rest of the country- they advise checking with them before travelling.
Malaysia, the Philippines, China and Australia have advised their citizens to avoid travelling to Bangkok and its surrounding areas and to monitor the situation closely.
In countries that normally send high numbers of people to Thailand, airlines have cancelled flights, tour operators report bookings have fallen dramatically, and some insurers refuse to offer cover.
Everybody is hoping that after elections in February, the situation will return to normal. Meanwhile the Tourism Authority of Thailand is trying hard to play down the crisis and says tourists have not been targeted in the ongoing demonstrations and that it is business as usual in most parts of Bangkok.
On advice to customers from the medical tourism industry, there is a deafening silence.

International tourism grew 5% in 2013 with an extra 52 million arrivals, and similar growth is predicted for 2014.This is good news for medical, health and wellness tourism. It highlights the rise of China and Russia as leading outbound markets.
International tourist arrivals reached a record 1,087 million arrivals, according to the 2014 UNWTO World Tourism Barometer. Despite global economic challenges, international tourism results were well above expectations, with an additional 52 million international tourists travelling the world in 2013. For 2014, UNWTO forecasts 4% to 4.5% growth, again, above the long-term projections.
Demand for international tourism was strongest for destinations in Asia and the Pacific (+6%), Africa (+6%) and Europe (+5%). The leading sub-regions were South-East Asia (+10%), Central and Eastern Europe (+7%), Southern and Mediterranean Europe (+6%) and North Africa (+6%).
Taleb Rifai of UNWTO says, “The tourism sector has shown a remarkable capacity to adjust to the changing market conditions, fuelling growth and job creation around the world, despite the lingering economic and geopolitical challenges.”
UNWTO forecasts international arrivals to increase by 4% to 4.5% in 2014, again above its long-term forecast of +3.8% per year between 2010 and 2020. The UNWTO Confidence Index, based on the feedback from over 300 experts worldwide, confirms this outlook with prospects for 2014 higher than in previous years.
2014 regional prospects are strongest for Asia and the Pacific (+5% to +6%) and Africa (+4% to +6%), followed by Europe and the Americas (both +3% to +4%). In the Middle East (0% to +5%) prospects are positive yet volatile.
Europe led growth in absolute terms, welcoming an additional 29 million international tourist arrivals in 2013, raising the total to 563 million. Growth (+5%) exceeded the forecast for 2013 and is double the region’s average for the period 2005-2012 (+2.5% a year). By sub-region, Central and Eastern Europe (+7%) and Southern Mediterranean Europe (+6%) experienced the best results.
In relative terms, growth was strongest in Asia and the Pacific (+6%), where the number of international tourists grew by 14 million to reach 248 million. South-East Asia (+10%) was the best performing sub-region, while growth was comparatively more moderate in South Asia (+5%), Oceania and North-East Asia (+4% each).
The Americas (+4%) saw an increase of six million arrivals, reaching a total of 169 million. Leading growth were destinations in North and Central America (+4% each), while South America (+2%) and the Caribbean (+1%) showed some slowdown as compared to 2012.
Africa (+6%) attracted three million additional arrivals, reaching a new record of 56 million, reflecting the on-going rebound in North Africa (+6%) and the sustained growth of Sub-Saharan destinations (+5%). Results in the Middle East (+0% at 52 million) were rather mixed and volatile.
Among the ten most important source markets in the world, Russia and China clearly stand out. China, which became the largest outbound market in 2012 with an expenditure of US$ 102 billion, saw an increase in expenditure of 28% in the first three quarters of 2013. The Russian Federation is the 5th largest outbound market.
The performance of key advanced economy source markets was comparatively more modest. France (+6%) recovered from a weak 2012 and the United States, the United Kingdom, Canada and Australia all grew at 3%. In contrast, Germany, Japan and Italy reported declines in outbound expenditure.
Other emerging markets with substantial growth in outbound expenditure were Turkey (+24%), Qatar (+18%), Philippines (+18%), Kuwait (+15%), Indonesia (+15%), Ukraine (+15%) and Brazil (+14%).

The number of infertile patients has been increasing worldwide. Responding to the associated rising demand for respective treatment the ideal would be fair access to fertility treatment at home for all patients. Since fertility treatment is not available or accessible in several countries, cross border reproductive care is a solution that enhances a patient’s autonomy and fits with the principles of freedom of movement of patients within Europe.
Fertility patients seek assisted reproductive technologies abroad for a variety of reasons and the reasons for traveling might also be different between countries. The most common reason is law evasion when the technique is either forbidden per se or when a particular group is excluded from treatment. Other potential reasons to seek cross-border care include cost, perceived effectiveness, accessibility, and availability of donor gametes from a variety of ethnic groups. Crossing national borders to receive fertility treatment poses special challenges for the continuity, quality, and ethics of care.

Temos has launched a new accreditation for the sector. ’Quality in International Reproductive Care’ takes into account good clinical treatment in assisted reproduction and good practice for cross-border reproductive care, both from the European Society of Human Reproduction and Embryology
The new product covers the following treatments and techniques for reproductive care:• Intrauterine insemination• In vitro fertilization• Intracytoplasmatic sperm injection• Blastocyst transfer• Cryopreservation of oocytes, zygotes, and embryos• Gamete donation• Surrogacy• Egg donation
The aim is to validate and optimize the facility’s medical and non-clinical services for medical tourists including the complete patients’ care cycle before travelling abroad, within the clinic and for the post-treatment and post-discharge procedures including the follow-up.
Any health care organization may apply if it is operating as a licensed health care provider, accepts international patients, and is offering reproductive care services according to the national law. It must also be managing international patients and intending to continue or extend that in the future. And at least 5 % of the patients are regional and or international patients. 
There are other requirements.
After the clinic has completed the self-evaluation form, the Temos team supports and accompanies the preparation phase until the onsite visit of the Temos assessors. Assessment is done by inspection onsite on the basis of professional judgement and clearly defined and standardized criteria. Further potential for improvement is discussed with staff and management onsite. In a detailed report all recommendations and demands are summarized. National norms, laws, different cultures, mentalities and quality approaches in different countries are taken into account for the overall assessment.
Claudia Mika of Temos comments, “IVF centres have already applied for this and will start their preparation within the first half of 2014.”

Just Save Lives has expanded its range of services and business partners to provide organ transplant tourism packages for those in need of life saving surgery. Many people will experience partial to total organ failure in their lifetime as a result of bad lifestyle choices or genetic predispositions, but no one wishes to die from it.
In the USA, as in many other countries, long organ transplant lists mean that people can take years to get to the front of the queue, leaving many seeking alternatives.
Just Save Lives is a company providing legal guidance, document translation, insurance reimbursements together with professional guidance including locating hospitals and experts and recommending doctors.
The company now offers medical tourism packages for Americans seeking major organ transplants in leading medical institutions in Israel.
The company provides the full spectrum of services required to take care of every aspect of a medical transplant abroad including initial medical advice and medical summary, consultation regarding the most suitable hospital, medical staff and more to ensure every aspect of the procedure is to the client’s satisfaction.
Just Save Lives offers liver transplant surgery, kidney transplant procedures and even heart transplants.
The information on each procedure is presented as a package deal showing exactly what is included at every step of the process.
Just Save Lives partners with Israeli medical tourism company Leshem Shamaim– which has proven knowledge and experience in the field of organ transplantation.

Polys Georgiades of the Medical Services Promotion Agency urges the Cyprus government to help and finance medical tourism, as it will bring economic benefits and without help the country will miss out on the sector.
Polys Georgiades explains, "The state should meet its commitment and help the private sector both in the development of infrastructure and in boosting credibility for Cyprus internationally."
Georgiades says that after the events of March 2013 with the impairment of insecure deposits and Cyprus’ banking restrictions, all designs and strategies for medical tourism were marginalized, since clinics, hospitals and all health service providers have given priority to ensuring their everyday viability.
He stresses that in the current economic conditions there is a need for health providers to stop depending on the internal market, by attracting patients from abroad; "We must pay attention to alternatives to attract people, beyond the sun and the sea. Medical tourism is a good opportunity, because we have the infrastructure and can provide the service."
Georgiades says that Cyprus will have to build its own identity as a medical tourist destination and will have to survive the tough competition from more than sixty countries where medical tourism is a national industry. He adds that Cyprus must meet international standards and introduce reforms to become a valuable destination for medical travelers.
He argues that Cyprus has the necessary medical and health infrastructure, and a high level of service. Stressing that health tourists can combine their treatment with vacations in luxurious hotels, he adds that specialized surveys have shown that the country can develop phototherapeutic tourism, since the sun has special properties for the treatment of individuals who have symptoms of depression due to lack of adequate sunshine in their country.

German citizens are becoming more aware of the importance of staying healthy and energetic. Increasingly, they are taking health vacations to reduce everyday stress or to stay fit for their jobs. Over the past five years, holidays at wellness and spa resorts have risen by 30 %. By contrast, medical travel has declined, as according to the findings of the World Travel Monitor, commissioned by ITB Berlin, over the same period the number of cure, rehabilitation and hospital stays abroad has fallen by 18 %.
At 3.3 million vacations, equivalent to 4.6 % of all trips abroad, Germans are more interested in foreign health and medical tourism than their European neighbours. Health and medical travel accounts for a total of 9.4 million trips or 2.4 % of all European travel abroad. Across Europe, over the past five years health vacations have increased by 38 %. Medical tourism has also risen by 24 %.
Martin Buck of ITB Berlin comments, “Everywhere in Europe health vacations are becoming more popular. This is a big opportunity for organizers, hotels and destinations to expand and improve their services.’’
Germans and Russians are much keener to take health vacations than their European neighbours. The German market for health vacations abroad is approximately six times the size of Russia’s, but with German citizens medical tourism accounts for only 22 % more. The French market is the third largest for foreign health trips, while The Netherlands is the third largest for medical tourism abroad.
Among German citizens the most popular foreign destination for health trips is Spain, followed by Italy and Austria. The countries most visited for medical reasons are Poland, the Czech Republic and Hungary. In Europe as a whole, the most popular countries for health trips are Spain, Italy and Austria, while Hungary, Germany and the Czech Republic are the leading destinations for medical tourism.
According to the survey, socio-demographics also play a part. At an average age of 48, Europeans taking health vacations are younger than people travelling for medical reasons, who are 53. German travellers in both categories are older than the European average. People taking health vacations are 52 and those travelling for medical reasons are 61. Women prefer to travel for medical reasons rather than take health vacations. However they outnumber their male counterparts in both categories.
Europeans say that when taking health vacations they prefer relaxing (50 %), followed by walking / hiking and swimming (43 % each). Among Germans, the most popular activities are walking / hiking (48 %), relaxing (47 %), followed by swimming (44 %). Germans are slightly keener on wellness programmes (30 %) than their European neighbours (26 %). By contrast, massages are less popular with Germans (15 %) than with Europeans as a whole (26 %).
At growth rates of slightly under 100 % and 100 % plus respectively, at 0.4 million and 0.3 million trips each in 2010, at 3% each of the holiday market, Russia and China are developing into attractive markets for health vacations, particularly for their neighbouring countries.