No. 4, July 2019 FITM Special Wellness Zones for Forum on Indian Traditional Medicine Wellness Tourism: Exploring prospects of creating dedicated ISM hubs Introduction have drastically changed the disease Tourism industry is huge in India. It and mortality pattern of the world. is the largest service sector industry With the advancement in medical and second largest foreign exchange sciences, humanity has been able earner. Tourism also provides for 9 to eliminate diseases such as small per cent of total employment in the pox and we are making headways to country. It is for these reasons that eradicate Polio, Malaria and Measles. tourism has been identified as an These advancements have led to a important service sector industry nosedive decline in the incidence of with high spill over effects in the communicable diseases, particularly in Economic Survey of India, 2018-19. the developed countries. In 2016, only A special emerging area under 20 per cent of global mortality was tourism is wellness tourism, which attributed to communicable diseases. is travelling to seek improved health The same figure was 56 per cent in the and well-being through physical and WHO African region (WHO Global spiritual activities (Wego, 2015). India Health Estimates, 2016). has the potential to become the global While the global development and market leader in Wellness Tourism. urbanisation did help in reducing the The country is endowed with diverse incidence of communicable diseases, climatic zones, each with different other ailments such as stress, anxiety natural environment. and depression and other mental This makes India, one of the few disorders are on the rise. It is no countries that can offer diverge range wonder that mortality due to suicides of tourism experiences within its and cardiac arrest have become borders. Coupled with the heritage common causes of deaths, particularly of millennia old Indian Systems of in the developed world. According to Medicine (ISMs), the country can Global Health Risk report (2009), 9 out project itself as a unique destination of top 10 leading causes of mortality in for wellness tourism. This policy brief the world can be attributed to lifestyle 1 explores the advantages that India will choices. have in setting up Special Wellness In the context of above mentioned Zones (SWZs) that will promote both changes, the concept of wellness FITM POLICY BRIEF ISMs and Tourism, as well as create assumes a paramount position. The employment opportunities. National Accreditation Board for Economic growth, development Hospitals & Healthcare (NABH) and urbanisation across the globe defines the concept of wellness as This Policy Brief has been prepared by Prof. T.C. James, Visiting Fellow, RIS and Mr. Apurva Bhatnagar, Research Assistant, RIS. Box 1: Wellness Towns in China China has already established dedicated wellness towns in each of its province to promote domestic wellness tourism. For example, Miyi county of Panzhihua, Sichuan province has been developed as the go to place for wellness tourism for people of South-western China. Miyi is now taking strides to portray itself as a nationwide resort for preventive healthcare and wellness.5 Towns such as Miyi, have been developed in China with the support and cooperation from both Chinese central government and Sichuan provincial government. The support comes in the form of tax rebates and subsidies to the service providers. Another important wellness zone that China has created is the Hainan Island, also known as the Hawaii of China. The visa-free island has been established as a major wellness zone to attract foreign visitors. The island is emerging as a major global wellness tourism hotspot, which has been visited by over 800,000 tourists from Russia and Central Asia since 2010 (Lo and McGroarty, 2019). Almost 80 percent of these tourists try some form of TCM therapy during their stay.6 Source: Deccan Chronicle, April 5, 2018.10 a state of optimal health covering physical, Africa, and sub-Saharan Africa accounting for mental, social, spiritual aspects of an individual. 57 per cent of the increase in wellness trips since In this regard, NABH also defined wellness 2015.3 The large developing economies of BRICS intervention as those interventions that do not nations have a long history of usage of Traditional require overnight stay at the wellness centre Medicine and now these countries are redefining for medical reasons; and, leaving the treatment wellness services in the moulds of Traditional after any stage should not cause any harm to Medicinal Knowledge.4 To capture the growing the individual.2 Even in international forums, market of wellness tourism, many developing wellness forms an integral part of overall health countries have also developed certain areas, policies. The Sustainable Development Goal dedicated to attract wellness tourism. Box 1 (SDG) 3 emphasises on ensuring healthy life and points out major initiatives undertaken by China promoting wellness for all at all ages. Promoting in order to promote wellness tourism by creating healthy lifestyles is a prerequisite if one hopes dedicated wellness towns. to attain that goal within stipulated time period. With the rise in disposable incomes of Wellness Tourism in India urban population in developed and developing It is interesting to note that wellness may have countries, many travellers now seek wellness and been a relatively new term in the international recreation as important motives for travelling. platforms; it has been an age old concept in It is for this reason that ‘Wellness Tourism’ has Indian subcontinent. In India, the Traditional experienced a surge in recent years. A report Medicine system of Ayurveda and other ancient by Wego, a major travel search engine in Asia texts have defined the concepts of do’s and don’ts Pacific, defines Wellness Tourism as travelling related to diet, conduct, and other daily activities to seek improved health and well-being through for healthy living.7 These concepts form the basis physical and spiritual activities (Wego, 2015). of modalities for prevention of diseases and The wellness tourism market was valued at USD restoration of health and wellness. Preventive 639 billion in 207 by the Global Wellness Institute. healthcare services have been an integral part of Between 2015 and 2017, the market grew at the Ayurveda since ancient times. Yoga is yet another rate of 6.5 per cent, which is twice as fast as the Indian system that has proven to be a highly general travel Industry (Schweder, 2019). effective preventive healthcare practice. Yoga has According to Global Wellness Trends Report also been found effective against many mental 2019, wellness tourism growth is very much a ailments such as depression and anxiety. It’s no tale of developing markets, with Asia-Pacific, wonder that the alternative medicine systems Latin America-Caribbean, Middle East-North of Ayurveda, Unani, Siddha, Naturopathy and Homeopathy as well as the non-drug therapies 2 FITM Policy Brief No. 4, July 2019 including Yoga and meditation are increasingly higher in the Asian region. During 2015 to 2017, becoming popular among foreign patients as the region witnessed a growth of 13 per cent per non surgical methods of treatments for various year in wellness tourism, which is a much higher ailments (Begum, 2013). It is because of our rich growth rate compared to any other region of the 8 heritage of wellness and Traditional Medicine world. It is only practical, that India should now healing that in a 2015 survey by Wego, three use this opportunity to place itself as the major Indian cities made it to Top 15 wellness cities in player in this sphere. Asia (Wego, 2015). The Ministry of Tourism has identified Travel and tourism is a huge industry in India. wellness tourism as one of the nine niche tourism It is the largest service sector industry and second products that India can sell in order to overcome largest foreign exchange earner. Internationally, seasonality in tourism and promote India as an India has already positioned itself as a major all-year travel destination attracting tourists with tourist hotspot. India received more than 10 specific interest. The Ministry has also set up million Foreign Tourist Arrivals in 2017 alone. National Wellness and Medical Tourism Board The Foreign Tourist Arrivals of India has been to act as an umbrella organisation to promote growing steadily with the Compounded Annual wellness tourism in India in an organised 9 Growth Rate (CAGR) of 8.15 per cent from 2000 manner. In this regard, the Ministry of Tourism to 2017. As can be seen from Figure 1, the growth provides financial assistance to the National in foreign tourism has been accompanied by an Accreditation Board for Hospitals & Healthcare almost equal rate of growth in foreign exchange (NABH) certified wellness service providers to revenue that resulted from foreign tourism. It take part in Tourism Fairs/ Events/ Conferences 10 is impressive to note that India’s rank in World etc, across the globe. Moreover, Indian Tourist Arrivals was 26th whereas it ranked 13th government has identified major tourist hotspots globally in the amount of global tourism receipts. in each of its state. Enhancing the connectivity, via roads and airways, between these hotspots We have already seen that the global wellness is expected to boost economic activity along the tourism market is booming. The growth is even entire route and also reduce the migration of the Figure 1: Foreign Tourist Arrivals and Foreign Tourism Receipts in India, 1996-2017 Source: Indian Tourism Statistics at a Glance, Ministry of Tourism, Government of India. FITM Policy Brief No. 4, July 2019 3 Figure 2: Compounded Annual Growth Rates of Sectors of the Wellness Industry Source: FICCI and EY, 2016. rural labour force that forms a major proportion industry in India. One such potential lies in of the total labour force (Economic Survey, 2019).