Medical Tourism in Developing Countries

CHAPTER 7Inequalities in Health Care and theRole of Macroeconomic PolicyHealth care is in crisis all across the globe. There are few sectors inwhich so much progress has been made, and still so much remainsto be done. Although there is no doubt that human longevity hasincreased as more diseases are under control and better nutrition has spreadto more people, those advances have been offset by the rise of new diseases(such as AIDS and SARS) and new means of spreading them. Health crisesalso exist because poverty still has not been eradicated in many parts of theworld, resulting in widespread malnutrition, unsanitary conditions, illiteracy,and a lack of health care. In addition, there are crises due to spiraling costsof medical care and the inability of public or private sectors to spread basicand preventive health care. These problems are especially acute in developingcountries. Global expenditure on health exceeds $56 billion per year, butless than 10 percent of that is directed towards diseases that affect 90 percentof the population. 1 Moreover, in the last 20 years, pharmaceutical companieshave introduced 12,000 new compounds, of which only 11 fight tropicaldiseases. Developing countries are even more strapped for health-careresources, both human and physical, than the more developed countries,and this strain on resources limits the quantity and quality of health carethat their populations receive. Although there is enormous variety amongcountries with respect to public health problems, without a doubt it is Africathat hosts the greatest concentration of pervasive problems and poses thegreatest challenges for disease eradication and improved health.Medical tourism contributes to the health-care problem as well as to itssolution. Indeed, it contributes to the crisis in health care insofar as it hasthe effect of creating a dual health delivery system, one for rich foreignersand one for poor locals. It can lead to the draining of public sector fundsand the implementation of policies biased in favor of commercial medicine.