Medical Tourism in Developing Countries

88 ● Medical Tourism in Developing Countrieswell as health and education services, improves the overall investment environmentfor tourism and thus attracts investors. It provides those inputsthat private tour operators as well as hospitals offering medical servicesrequire (such as roads, bridges, and airports) but won’t invest in themselves.The World Bank has considerable experience in infrastructure investment,including hospitals, roads, water and sewage systems, communications, andtransport systems. Indeed, most of their loans to LDCs have been majorinfrastructure development projects. 95When LDCs lack resources for the development of tourist facilities, theyturn to international lending institutions. These include multilateral bankssuch as the World Bank and the Inter-American Development Bank.Also, UN agencies such as UNDP and the Global Environment Facilityare involved in tourism projects, although not in a lending capacity. TheUNWTO, an association of 138 government tourism boards with some350 affiliate members, coordinates with multilateral and bilateral aid agenciesand development banks in the provision of tourist related projects.However, it is the World Bank that potentially has the largest role in tourismdevelopment as its projects are based on the linkages between tourismand sustainable development in the economic, environmental, and socialareas. 96International multilateral institutions provide LDCs assistance in formulatingtourism policies and integrating tourism into broader policy frameworks.They help out with feasibility studies and risk assessments. Theymight even train local and central governments to build capacity and managegrowth in that sector. Among multilateral institutions, it is theUNWTO that is most heavily involved in counseling countries on how toattract foreign investment. It also provides technical assistance to destinationLDCs.Charities and NGOsThere are numerous civil society and professionals groups working toimprove health in developing countries. They include, among others,Health Action International, the Global Fund, Interactive Health Network,Healthlink Worldwide, Medact, Médecins Sans Frontières, NGO Forumfor Health, Physicians for Social Responsibility, and the People’s HealthMovement. Charitable foundations have sprung up (the biggest and mostambitious is the Bill and Melinda Gates Foundation). With respect to tourism,some NGOs have also recently emerged, calling attention to the negativeaspects of tourist development and making an effort to include localpopulations in tourism decisions. At this point, NGOs have not paid any