| Verified against primary record | |
| National target | 20 per cent annual growth in health exports with the development of health tourism[1] |
|---|---|
| Thalassotherapy centres (2007) | 33[1] |
| Private clinics (2007) | 103[1] |
| Private inpatient beds | Rose from 796 in 1987 to 2,578 in 2007[1] |
| Household share of health expenditure (2005) | 51.41 per cent, up from 48.1 per cent in 2000[1] |
| Total health expenditure (2005) | 5.9 per cent of GDP, up from 3.2 per cent in 1980[1] |
| Private sector share of hospital admissions | About 15 per cent, while the public sector handled over 80 per cent of hospitalisations[1] |
| Physicians (2007) | 5,891 general practitioners and 5,675 specialists, a majority of both in the private sector[1] |
| Independently reported | |
| Regional pattern | Visa restrictions were said to have pushed many Middle Eastern patients toward Southeast Asia[3] |
| Bands apply only to the rows beneath them. The source is the country cooperation strategy for 2010 to 2014 and its underlying data is from 2005 to 2007, so these figures describe capacity and policy intent from nearly two decades ago. No more recent Tunisian country cooperation strategy was located. The strategy sets a growth target but reports no count of foreign patients and no revenue from health exports, so whether the target was met cannot be assessed here. No typical cost range is given because no official Tunisian price schedule for foreign patients was located. | |
Medical tourism in Tunisia is one of the few cases in this series where the activity appears as a stated national objective in a World Health Organization country strategy rather than only in commercial promotion. The strategy for 2010 to 2014 records a national target of 20 per cent annual growth in health exports with the development of health tourism, and describes a private sector built around that ambition, including 33 thalassotherapy centres.
Health exports as policy
The country cooperation strategy for WHO and Tunisia covering 2010 to 2014 lists among national targets a 20 per cent annual growth in health exports with the development of health tourism, specifying hydrotherapy and thalassotherapy meeting international standards. It records that the government’s strategic programmes include developing health service exports, and gives the prospect of exporting health care services as one reason quality of care matters.[1]
The same document records a second kind of export. Discussing health worker unemployment, it gives the envisaged solution as exporting health cadres, and separately notes that other countries send staff and technicians to Tunisia for training.[1]
An explicit national health-export target of this kind is rare in the documents surveyed for this series. The equivalent current strategy for neighbouring Morocco, produced by the same WHO regional office, makes no reference to medical tourism, health tourism, health service exports or foreign patients at all, which indicates the Tunisian target reflects a deliberate national choice rather than a standard feature of the document format.[2]
Those two policies sit uneasily together, and the tension is worth naming. A country that exports clinicians to relieve domestic unemployment is reducing the workforce available to treat the foreign patients it also intends to attract. The strategy sets both as objectives without reconciling them.
The private sector the target rests on
Private inpatient beds rose from 796 in 1987 to 2,578 in 2007. By 2007 the private sector comprised 103 clinics, 6,505 medical offices, 1,790 dental surgeries, 1,777 pharmacies, 237 testing laboratories, 1,128 haemodialysis machines and 33 thalassotherapy centres. The strategy records that the private sector holds most of the country’s heavy medical equipment and is concentrated in Greater Tunis and the coastal regions.[1]
Its clinical share is nonetheless modest. The private sector provides an estimated 15 per cent of hospital admissions, about 6 million consultations and 6 to 10 per cent of deliveries, with little preventive activity, while the public sector handled over 80 per cent of hospitalisations. In 2005 the private sector accounted for 48.1 per cent of national health expenditure, roughly equal to the public and parapublic sectors combined at 50.6 per cent.[1]
A sector taking nearly half of national health spending while delivering about 15 per cent of admissions is the clearest indicator in the Tunisian record of where the money goes, and it is the capacity any health-export strategy would have to draw on. The concentration of that capacity on the coast, where the thalassotherapy centres also are, explains why Tunisian health tourism has historically been described in terms of spa and wellness treatment alongside surgery.
Workforce and financing
In 2007 Tunisia had 5,891 general practitioners, of whom 2,431 were public and 3,460 private, and 5,675 specialists, of whom 2,630 were public and 3,045 private, giving about 1,741 inhabitants per general practitioner and 1,807 per specialist. Paramedics numbered 35,260, overwhelmingly public at 33,249 against 2,011 private, and the private sector had 1,372 nurses.[1]
Total health expenditure rose from 3.2 per cent of gross domestic product in 1980 to 5.9 per cent in 2005, and from 143 million to 2,250 million Tunisian dinars over the same period. Households financed 51.41 per cent of health expenditure in 2005, up from 48.1 per cent in 2000. The population was estimated at 10,225,100 as at 1 July 2007, 66.17 per cent urban.[1]
A household share above half, and rising, means Tunisians were already paying directly for most of their own care while the state pursued health exports. The strategy lists controlling health expenditure growth and reducing regional disparities among national priorities, which indicates the policy tension was recognised domestically.[1]
What the record does not show
The strategy sets a target but reports no baseline and no outcome. There is no count of foreign patients, no health-export revenue figure and no breakdown by treatment or country of origin, so the 20 per cent target cannot be assessed against performance using this document. No more recent Tunisian country cooperation strategy was located for this article, which means the most recent official statement of Tunisian health-export policy found here is from 2010 and rests on data from 2005 to 2007.
Tunisia is widely promoted as a destination for cosmetic surgery, dental treatment and thalassotherapy, with Libya, Algeria and France commonly named as source markets. No official Tunisian figure confirming any of that was located, and none has been estimated.
Regional context
A 2015 briefing by an economist at the United States International Trade Commission, published as the author’s own views rather than those of the Commission, recorded that visa restrictions had pushed many Middle Eastern patients toward Southeast Asia. It names no countries of treatment or origin and is a decade old, and is included as the only sourced statement on regional patient movement located for this entry.[3]
Limits of the evidence
Every figure here is from a single document published in 2010 with underlying data from 2005 to 2007, and the age of that data is stated wherever the figures appear rather than left implicit. The document is marked restricted distribution and carries no ISBN. A portion of it was not read, because the text exceeded what could be retrieved in one pass, so provisions in the final section may not be reflected here. No Tunisian ministry statistic on foreign patients was located.
See also
- Thermal tourism and medical spa tourism, the thalassotherapy sector the target names
- Medical tourism in Morocco, whose equivalent strategy sets no such target
- Medical tourism and health workforce migration, given the policy of exporting health cadres
- Medical tourism and public subsidies, where health export is a state objective
- Destination markets in medical tourism, the category Tunisia set out to join
References
- World Health Organization. Country Cooperation Strategy for WHO and Tunisia, 2010-2014. Document EM/ARD/042/E, restricted distribution, 2010, printed by the WHO Regional Office for the Eastern Mediterranean, Cairo. Verified against primary record: the document was opened and the national target of 20 per cent annual growth in health exports with the development of health tourism including hydrotherapy and thalassotherapy meeting international standards, the inclusion of health service export development among government strategic programmes, the reference to exporting health care services as a reason quality of care matters, the stated solution of exporting health cadres to address health worker unemployment, the note that other countries send cadres and technicians to Tunisia for training, the rise in private inpatient beds from 796 in 1987 to 2,578 in 2007, the 2007 private sector counts of 103 clinics, 6,505 medical offices, 1,790 dental surgeries, 1,777 pharmacies, 237 testing laboratories, 1,128 haemodialysis machines and 33 thalassotherapy centres, the private sector’s holding of most heavy medical equipment and its concentration in Greater Tunis and the coastal regions, its estimated 15 per cent of hospital admissions, about 6 million consultations and 6 to 10 per cent of deliveries, its 48.1 per cent of national health expenditure in 2005 against 50.6 per cent for the public and parapublic sectors, the public sector handling over 80 per cent of hospitalisations, the 2007 physician counts of 5,891 general practitioners and 5,675 specialists with their public and private splits and the inhabitants-per-doctor ratios, the paramedic and nurse counts, the rise in total health expenditure from 3.2 per cent of GDP in 1980 to 5.9 per cent in 2005 and from 143 million to 2,250 million dinars, the household share of 51.41 per cent in 2005 against 48.1 per cent in 2000, the 2007 population estimate of 10,225,100 and urbanisation of 66.17 per cent, the public facility counts, the six areas for WHO cooperation, and the national priorities of reducing regional disparities and controlling health expenditure growth were read directly. The document carries no ISBN and part of its final section was not retrieved. Retrieved 23 October 2026.
- WHO Regional Office for the Eastern Mediterranean. Cooperation strategy between Morocco and WHO for the period 2023-2027. Published 28 May 2023, 64 pages, ISBN 9789292741006. Verified against primary record for comparison only: the publication entry was opened and the absence of any reference to medical tourism, health tourism, health service exports or foreign patients was read directly, and is used here solely to show that the neighbouring country’s current strategy sets no comparable target. Retrieved 23 October 2026.
- Chambers, A. Trends in U.S. Health Travel Services Trade. Office of Industries, United States International Trade Commission, Executive Briefing on Trade, August 2015. Independently reported: the briefing was opened and the statement that visa restrictions had pushed many Middle Eastern patients towards Southeast Asia was read. The briefing states that the views expressed are the author’s and not those of the Commission, and it is placed in this band for that reason. Retrieved 23 October 2026.
Sourcing note: the age of the source is stated throughout rather than once, because a 2010 strategy resting on 2005 to 2007 data cannot describe Tunisia today and presenting its figures without that qualification would mislead. The entry states that the 20 per cent target cannot be assessed, since the document gives neither a baseline nor an outcome. Tunisia’s commercial promotion as a destination is described as promotion and is not quantified. Nothing has been estimated.