The Challenges of Travel Medicine in the 21st Century

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Travel medicine has emerged as a new field of medicine, moving to an evidence based body of knowledge concerning risk assessment and measures to protect the health of travellers. Most of travel medicine concentrates on tourists from North America and Europe leaving for international destinations, many being low or middle income countries involving a higher risk of acquiring infectious diseases. This paradigm is changing rapidly. With the increasing mobility of populations, whether migrants, tourists, businessmen, students, soldiers, humanitarian workers, pilgrims, refugees or medical tourists, it is becoming evident that the diversification of globally mobile travelers is posing new challenges to the travel medicine community. Perception of risk, behaviour, exposure to risks and access to health services vary enormously. Nonetheless all contribute to the global circulation and potential spread of known or emerging pathogens. From an epidemiological and public health perspective a more global encompassing approach to health issues related to population mobility is urgently needed.

With globalisation new emerging economies are growing in many parts of the world, new patterns of travel and mobility appear. The sharpest increases in travel are observed in Asian and in Latin American regions where intra-regional and in-country travel is rising. The majority of these new travellers are urban dwellers often unaware of the existing risks gradients within their own country when they move to rural destinations. Thus travel medicine has to expand from the current international/across boarders approach to a practice based on risk assessment analysis and prevention across different prevalence gaps, wherever and for whomever they are of relevance.

Climate change, security issues, economic fluctuations, demographic shifts and the threat of emerging diseases will also reshape the future of travel and mobility trends. All will influence travelers’ health and pose new challenges to travel medicine in the forthcoming decades.