Changing profile of India's medical tourism exports amid Bangladesh unrest

The quality and affordability of India's healthcare market make it a top choice for people from developing nations. But recent political unrest in Bangladesh may affect India's medical tourism exports

The political upheaval in Bangladesh has once again turned the attention back to India’s medical tourism exports. The neighbouring country is India’s leading contributor to healthcare tourism.

A total of 4,49,570 Bangladeshi medical tourists thronged the Indian shores for their medical treatment in 2023, a 37.46 per cent rise from 2022. Their share in India’s Foreign Tourist Arrivals (FTAs) for medical reasons was 42.48 per cent in 2016, which has jumped to 70.85 per cent in 2023.

While the recent political developments in Bangladesh are expected to impact India’s overall medical tourism services exports, the issue runs deeper, with India’s health service exports having already declined by 38.58 per cent between FY15 and FY24.

A review of India’s Balance of Payments data shows the expenditure on health-related travel by foreigners in India has plummeted from $254 million in FY15 to $156 million in FY24.

Even though health services exports by India have been rising for the past two years, they are still below the pre-pandemic level. The post-pandemic recovery has not been enough to counter the pandemic-induced fallouts on India’s health services exports.

Notably, foreigners’ expenditure on procuring health services in India began declining even before the pandemic started. Such expenditure fell drastically from $288 million in FY17 to $105 million in FY19. Meanwhile, India’s health service imports have been rising since FY21, which have almost doubled from $29 million in FY15 to $56 million in FY24.  

India aims for global wellness leadership

To tap the potential of medical value travel (MVT) and wellness tourism, the government has taken some measures. In 2014, the government launched e-Visa facility which was expanded to include medical visits as well. Currently, e-visa is available for the citizens of 172 countries in eight categories out of which four pertain to medical tourism.

The Ministry of Tourism also came out with a National Strategy and Roadmap for Medical and Wellness Tourism in 2022, apart from establishing a Medical and Wellness Tourism Promotion Board.

The government has decided to promote India as a global hub for MVT and wellness tourism under the brand ‘Heal In India’ by bringing in all stakeholders in one place and working together with Indian Missions abroad, foreign governments and companies. Tele-medicine has been the focal point of this campaign as it plays a crucial role in pre and post-operative consultation.

It is also providing financial assistance to set up Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUSH) super-specialty hospitals to promote alternative medicinal systems.

India Tourism Statistics reports and Monthly Tourism Statistics documents from 2014 to 2024 state that the country witnessed an inflow of 1,84,298 Foreign Tourist Arrivals (FTAs) for medical reasons in 2014 which reached its peak of 6,97,357 in 2019, just a year before the pandemic.

Surge in medical FTAs post-pandemic

FTAs for medical reasons came down to 1,82,945 in 2020, albeit the numbers have increased as the pandemic subsided and reached 6,34,520 in 2023. The FTAs for medical reasons grew by 244.29 per cent from 2014 to 2023. These figures also include the visas given to Medical Attendants (patient’s family members) to visit India.

India receives a bulk of its medical tourists from least developed and developing Asian, African countries and Central Asian Republics.

While Bangladesh maintains the top spot for medical FTAs to India between 2016 and 2022, the composition of the remaining top 10 countries sending medical tourists to India has changed over time.

Afghanistan featured in the top three countries sending their medical tourists to India between 2016 and 2021. But it was not even among the top 10 countries in 2022. That’s possibly because of Taliban takeover-induced political unrest in the country and restrictions on commercial flight movement on the India-Afghanistan route.

Two countries ravaged by war and civil strife, Iraq and Yemen, continue to send a major share of India’s medical FTAs with a 78.56 per cent rise in medical tourists from Yemen from 2016 to 2022.

Medical tourists from Maldives dropped 77.27 per cent between 2016 and 2022. It reached its lowest in 2019, sending only 7,190 medical tourists to India, occupying the seventh position.

Four African countries – Kenya, Sudan, Nigeria and Tanzania – regularly featured in the top 10 list except in 2016 and 2018. Sudan and Myanmar which were absent in 2016, appeared in the 2022 list, possibly because of worsening domestic political situations. 

Global appeal of India’s healthcare market

Rohit Azad, assistant professor at Jawaharlal Nehru University, New Delhi, said the quality and affordability of Indian medical care in the private sector makes it an attractive destination for people in least developed countries and developing countries.

“India, with the coverage of different diseases and the technology usage in health care is at par with many first-world countries. That’s why it receives medical FTAs from these regions as the cost would be much higher in developed countries,” he said.

Pakistani medical tourists traveling to India plummeted significantly over the years because of rising political tensions and visa restrictions on people’s movement across borders. Pakistan sent 6,649 medical tourists in 2016 (9th position) but didn’t feature in the top 10 list any further.

Nisha Taneja, a professor at Indian Council for Research on International Economic Relations (ICRIER) is an advocate for liberalising medical tourism visas for Pakistani citizens on humanitarian grounds. “If we could send humanitarian aid to Afghanistan, then why not allow medical tourists from anywhere in the world? Even during the roughest of times between the two countries, medical tourism was never affected. So, the humanitarian angle should never be ignored,” said Taneja.

Taneja noted that medical tourists’ numbers are rising but problems remain. “Medical tourists aren’t aware of what India has to offer and where to go. If you want to build a brand, it can’t be just word-of-mouth. The action plan is missing,” she added.

On regional competition to attract medical tourists from countries like Malaysia and Thailand, Taneja said Thailand has created a niche market in cosmetic surgery. “I think the way they have branded themselves is way superior to us. We are not doing anything to create a brand for ourselves. Even wellness is a niche area for us that we can really market, (but) we are not getting (medical) tourists from the Western and the developed countries. So, we can target those markets for the wellness segment,” she suggested.