In 1995, the European Spas Association was founded in Brussels – a milestone that fundamentally changed what European spa and health resorts stand for.

For the first time, an organisation brought Europe's diverse health and spa destinations together under one roof. The ESPA established common quality standards, put the industry in the spotlight and paved the way for a modern-day, internationally networked health and tourism landscape.

In the interview, Csilla Mezősi, Secretary General of the European Spas Association, explains how taking this step created standards, promoted innovation, as well as how health tourism must be defined today and which trends – from prevention to longevity concepts – will determine the future.

In 1995, the European Spas Association was founded as the umbrella organisation of the spa industry, representing 20 EU member states. Why was this step so significant for the industry at the time?

The founding of the ESPA in 1995 was a milestone because for the first time an established, yet diverse range of European spa and health resorts came together under one roof.

At a time of deepening internal market structures in the EU, the ESPA let the industry speak with one voice, developed common quality standards, and was able to represent its interests at European level.

This laid the foundation for positioning spas not only as local or national health resorts, but as integral to the European health and tourism landscape.

Since its launch, how has the ESPA shaped cross-border cooperation and standards in spa and wellness tourism?

The ESPA has played a key role in sharing knowledge and best practices among member states. Joint research projects, European conferences and initiatives such as the ESPA Innovation Awards have resulted in the creation of a benchmarking culture.

In addition, the ESPA has developed quality standards for hot springs and health destinations – currently under revision again – which now serve as orientation for investors, operators and visitors. In order to further highlight this industry, ITB Berlin has launched the Medical & Health Tourism segment and awards for the best health destination, efforts in which we are heavily engaged. These initiatives are helping to gain worldwide recognition for European health destinations. Not only has this work built trust with consumers, it has also promoted innovation and sustainability in the industry.

How would you define health tourism, and what separates health tourism from medical tourism on the one hand and wellness tourism on the other?

Health tourism is a global term for every kind of health-oriented activity that serves to maintain, promote or restore health. That includes hot springs and hydromineral baths, spa programmes, exercise therapies, nutritional counselling and stress reduction. What makes health tourism with natural remedies special is its firm basis in natural healing methods – spa waters, a healthy climate, mineral waters, therapeutic mud, mofettes and other locally based treatments.

These natural resources are specific to certain places, so people must physically visit them. The treatments are medically supervised, non-invasive and combine scientific evidence with proven preventive effects.

Medical tourism, on the other hand, encompasses medically required treatments such as operations or specialised medical procedures, while wellness tourism is more lifestyle-oriented, with a focus on relaxation, spa treatments, fitness, awareness and general well-being.

Beginning of a new era for Europe's spas © Unsplash/ Cloris Ying

Longevity concepts, currently trending and much talked about, often come up in the debate about wellness and health tourism. What does this mean for the industry in practice?

Longevity concepts stand for scientifically prolonging a healthy life. For the spa and health industry it means focusing more on prevention, personalised programmes and holistic lifestyle interventions. Hot springs and spas are ideal in that respect because they traditionally place an emphasis on prevention, regeneration and a sustainable lifestyle.

What is new is the combination of modern diagnostics, digital health solutions and evidence-based treatments together with the natural medicinal springs of our member resorts – ensuring personalised support for visitors on their way to better health and quality of life.

Will longevity concepts also transform the tourism industry? How are spas, clinics and resorts integrating them in their products?

Yes, longevity concepts will profoundly change the tourism industry and significantly increase the need for medical expertise. The focus is shifting away from traditional wellness towards scientifically based concepts that actively contribute to healthier ageing. More and more spas, clinics and health resorts are incorporating personalised programmes that combine exercise, nutrition, sleep, mental resilience and medical diagnostics.

Modern methods such as micronutrient analysis, biomarker diagnostics, biotechnology and stress and DNA testing are becoming part of comprehensive longevity strategies. At the same time, there is a growing demand for longer, more structured visits, as sustainable results can only be achieved through continuous support. Consequently, many resorts are being transformed into places where preventive medicine, lifestyle interventions and regenerating are seamlessly integrated.

What opportunities and challenges do you see for European spa and health tourism in general over the next ten years?

Over the next ten years, European health tourism will benefit from a growing awareness of prevention, health-conscious lifestyles and evidence-based health services. Europe's unique selling point – the combination of natural healing methods and an established medical tradition – means that many destinations are able to develop into innovative health centres.

At the same time, with digitisation making rapid progress, this opens up new opportunities. They range from personalised health programmes and telemonitoring to digital therapy support measures, which create a long-term connection between visitors and destinations beyond their stay.

However, adapting to the climate impact and economic change, dealing with growing skilled worker shortages and the pressure to fully implement sustainability measures in all areas are all ongoing challenges. Energy efficiency, mobility concepts and conserving resources have become decisive factors, ones which European programmes and funding instruments should give greater support to in the future.

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