The medical tourism axis is shifting East. Ian Youngman, healthcare and industry analyst, highlights the key points from a new report on Asia Pacific tourism and considers the implications for global medical travel.

Many in the medical tourism industry still talk about the USA and Europe as the main sources of international patient business, alongside assumptions that Asian medical travellers are low value or concerned only with the lowest price. This is now far from the case.

Over the last decade of tracking global medical tourism trends, we have found that international patient flows follow general tourism trends.

The publication earlier this year of the ‘Asia Tourism Trends – 2018‘ report by the World Tourism Organization (UNWTO), in partnership with the Global Tourism Economy Research Centre (GTERC), shows that a significant proportion of world tourism is now happening within Asia Pacific, and that markets such as China are not dominated by price. It also states that Asia and the Pacific have been outperforming all world regions in growth in international arrivals since 2005.

Asian markets, often thought of as sources of medical travellers, are now significant tourism destinations, with the infrastructure to support new investment.  This makes it much easier for medical facilities to set up and attract patients, which in turn is helping these destinations to attract domestic and international medical tourists.

The axis of medical tourism, following the overall economic, political and tourism worlds, is shifting from the West to the East. Businesses that do not grasp that will suffer.

UNWTO/GTERC Asia Tourism Trends 2018: Key findings

Asia and Pacific international tourist arrivals show fastest growth

Global tourism grew by a record 7% in 2017 to reach a total of 1.32 billion international arrivals. This is the highest increase in seven years, resulting from strong outbound demand from major source markets and a global economic upswing. Accounting for 37% of the world’s international tourism expenditure, the contribution of Asia and the Pacific to global tourism warrants attention.

International tourist arrivals in Asia and the Pacific grew 6% in 2017 to reach 323 million, a quarter of the world’s total. Of all world regions, Asia and the Pacific, the second-most visited after Europe, has grown the fastest in international tourist arrivals since 2005. Arrivals increased an average of 6% per year, above the world average of 4%.

Demographic and economic factors boost international travel in the region

Asia is the world’s largest region in both economic and demographic terms. With a population of 4.2 billion inhabitants, Asia and the Pacific is the world’s largest region demographically, with more than half of the population on the planet (56%).

In 2017, the GDP of Asia and the Pacific reached US$27.5 trillion, the highest of all world regions.

In 2016, Asia surpassed the Americas in economic output for the first time in history.

Between 2000 and 2017, Asia experienced the fastest economic growth across world regions, largely driven by China and India. Income levels have surged in Asia and the Pacific.

Rapid economic growth in a region with 56% of the world’s population, coupled with rising air connectivity, market openness and travel facilitation have boosted international travel in Asia and the Pacific, both within the region (intraregional) and to/from other regions (interregional).

Asia and the Pacific overtake Americas on international arrivals

Asia and the Pacific are the second most visited regions in the world after Europe, having overtaken the Americas.

Half of all international tourist arrivals in Asia and the Pacific were recorded in North-East Asian destinations in 2017 (160 million arrivals), while 37% were recorded in South-East Asia (120 million), 8% in South Asia (27 million) and 5% in Oceania (17 million).

The region earned US$390 billion in tourism receipts in 2017, or 29% of the world total, a share that has increased steadily from 17% in 2000. Asia’s share of receipts is above its share of world arrivals (24%), indicating that tourism spending in the region exceeds the world average.

Four Asian destinations (Thailand, Australia, Macao (China) and Japan) appear on the world’s top 10 ranking by international tourism receipts. Asian receipts per arrival exceed the world average: Asia earns an average US$1,200 from every tourist (arrival), above the world average of US$1,010.

China is the top destination in arrivals (61 million in 2017) and the sixth largest in receipts (US$33 billion), while Thailand is the top tourism earner (US$57 billion) and number two in arrivals (35 million arrivals).

In 2017, intraregional tourism (originating in the same region) accounted for some 257 million international tourist arrivals in Asia and the Pacific, or 80% of the region’s total, growing by 6%.

Key source markets to Asia

Europe is the largest source of interregional tourism for Asia and the Pacific, accounting for 11% of all arrivals from outside the region. European arrivals are highest in South-East Asia (15 million) and North-East Asia (10 million). The Americas are the second largest source of interregional tourism for Asia, accounting for 6% of arrivals.

Intraregional travel (within the region) accounts for 77% of Asian outbound travel and increased 6% in 2017. North-East Asian destinations account for 42% of all intraregional arrivals (originating in Asia). A large part of this is generated in the sub-region itself, particularly travel between Mainland China and the Special Administrative Regions (SARs) Hong Kong and Macao.

Asia and the Pacific play a vital role as a source market as well, fuelling much growth in both regional and long-haul destinations. 80% of these visits were concentrated in Asia destinations. Outside the region, 56% of the long-haul trips were to Europe. Outbound travel from Asia and the Pacific reached 335 million in 2017, a 7% increase from 2016.

Share of overall international tourism spend by Asian travellers is increasing

Asia and the Pacific travellers (both overnight and same day) spent US$502 billion on international tourism in 2017, some 37% of the world total, up from 24% in 2010.

China continues to lead global outbound travel after double-digit growth in tourism expenditure every year between 2004 and 2015, contributing to inbound volumes in many destinations in Asia and the Pacific, and around the world.

A total of 18 markets in the region spent US$1 billion or more on international travel in 2016.

Beyond China, other large tourism spenders in Asia include:

• Australia: the second largest tourism spender in the region, with US$34 billion recorded in 2017
• Republic of Korea: third largest with US$31 billion spent last year
• Hong Kong: fourth largest with US$25 billion
• India, Japan and Taiwan all spent US$18 billion on international tourism in 2017

Outbound international travel driven by China

Chinese travellers made over 130 million outbound trips in 2017, much of which was to Hong Kong (China), Macao (China) and other destinations in Asia. Hong Kong recorded 91 million departures in 2017, mostly to Mainland China.

Other large markets measured in departures are the Republic of Korea (27 million trips), India (22 million in 2016), Japan (18 million) and Taiwan (16 million).

European travellers to Asia double since 2000

The European Union has some of the largest and most affluent outbound travel markets worldwide. European markets generated 635 million tourist arrivals in world destinations in 2017.

While 85% of the traffic generated from Europe is intraregional, Asia and the Pacific received 35.5 million arrivals in 2017, which is more than double the 14.4 million recorded in 2000. European arrivals in Asia and the Pacific grew by an average of 6% a year between 2000 and 2017, the highest of all regions.

The top EU sources of travel to Asia and the Pacific were Germany (5.1 million), the United Kingdom (4.3 million) and France (1.4 million).

China is the top destination in Asia and the Pacific (61 million international tourist arrivals in 2017) and an increasingly attractive destination for Europeans. China received 5.5 million tourist arrivals from Europe in 2016; almost double those in the year 2000 (2.5 million). Of this total, 3.1 million came from the European Union.

Germany and the United Kingdom are the leading sources of EU travel to China, each generating about 0.6 million arrivals in China, followed by France with 0.5 million.

The Russian Federation is China’s largest extra-EU source market and its top European market overall, with 2 million arrivals in 2016, partly due to its long, shared border.

Europe is still a strong draw for Chinese travellers

The Chinese Government launched the Belt and Road Initiative (BRI) in 2013. In January 2018 the Trans-Pacific Maritime Silk Road and the Polar Silk Road were also introduced.

China’s BRI has helped to draw Chinese travellers’ interest towards Silk Road destinations, many of them in Europe. As a result, Central and Eastern Europe (CEE) destinations in particular have enjoyed strong growth in arrivals from China since 2013.

5.7 million Mainland Chinese tourists travelled to Europe in 2016, of which 3.5 million went to the EU. The European countries with the highest number of Chinese arrivals in 2016 were Italy, France, Germany and Spain. Chinese departure data shows France, the UK, Germany and Italy as the top destinations by first port of call. Strong growth to Central and Eastern European countries such as the Czech Republic, Croatia, Slovakia and Bulgaria shows that Chinese travellers are now branching out to non-traditional destinations that have a strong cultural appeal. Recent data shows the Czech Republic receiving half a million Chinese tourists in 2017, six times more than in 2010, while Hungary and Poland both recorded five times more, compared to 2010. Croatia saw the largest increase.

Among European destinations outside the EU, Switzerland received 1 million Chinese arrivals in 2016, Norway received 0.3 million and Iceland 0.2 million. These three countries benefit from being part of the Schengen Area, although they are not in the European Union. Iceland has seen a surge in Chinese arrivals this period, from 5,000 arrivals in 2010 to 160,000 in 2017.

Outside the Schengen Area, the Russian Federation received 1.3 million Chinese visitors in 2016.

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