Depuis les années 1990, on assiste au développement d’un phénomène nouveau, sorte de « shopping médical international » : des personnes ou des couples se déplacent à l’étranger pour recourir à certaines prestations de soins telles que des opérations dentaires, des actes de chirurgie esthétique, des techniques d’assistance médicale à la procréation ou encore des cures de thalassothérapie. Si l’Inde n’est pas une destination touristique de premier plan, elle constitue en revanche une destination privilégiée pour le tourisme médical en général, et pour le tourisme procréatif en particulier. Les raisons qui expliquent ce phénomène sont principalement juridiques (interdiction de la pratique de la gestation pour autrui dans de nombreux pays alors qu’elle est tolérée en Inde), financières (faible coût de cette pratique en Inde) et techniques (développement d’une offre de qualité en Inde, bénéficiant d’une labellisation internationale). L’article se propose de dresser un bilan des flux générés par le recours à la gestation pour autrui en Inde et d’analyser tant les causes à l’origine de ces flux que les conséquences en termes de développement touristique des territoires.
Since the 1990s, there has been the development of a new phenomenon, a kind of “international medical shopping “: individuals, people or couples traveling abroad to have access to certain health services such as dental operations, acts of cosmetic surgery, thalassotherapy cures or techniques of medically assisted procreation. India is has become one of the worldwide destinations for medical tourism in general and for reproductive tourism in particular. Medical tourism emerged as a growing sector in India in the 1990s as a result of liberalization and globalization of the Indian economy. The country is one of three main destinations for medical tourists in Asia, together with Thailand and Malaysia. The pull factors are the low cost of care combined with high quality hospital services and the high level of competence of doctors. This sector is mainly supported by large private hospital groups. The international patients come mainly from Asia, especially Bangladesh and Sri Lanka but also from Malaysia and Pakistan. There are also patients from developed countries (USA, UK) including among these, those with origins in the indian diaspora. The most sought care belong to various fields of surgery (cardiac surgery, bone marrow transplants, hip replacements, eye surgery and so forth) and care for wellness inspired by traditional Ayurvedic medicine. In recent years, India has become an increasingly popular destination in the field of assisted reproduction, and particularly in that of surrogacy. This element within a broader medical tourism differs markedly in the logic that contributes to the choice of India as the place of care. Indeed, the main reason is that surrogacy is legal in India in comparison with the ban on the practice in many countries. The lack of comprehensive and reliable data does not accurately assess the importance of this practice in India. However, the few studies in this area agree on the speed of its growth. India’s provision of reproductive services attracts reproductive medical tourists from the so-called Western countries along with many from Sri Lanka, Pakistan, Bangladesh, Thailand and even Singapore. In total, some sources estimate that nearly 12,000 foreigners come every year in India to resort to surrogacy reproductive services. Nationally, while these clinics are present in the whole of India, it is Gujarat State which enjoys the greatest visibility in this area and which has been dubbed the “world’s cradle”.. This contrasts the patterns by state of general tourism or even wider medical tourism, in which Gujurat does not feature as a lead state of choice. In 2014, the state received only 2.4% of domestic tourists (about 31 million people) and 1.04% of foreign tourists (about 236,000 people). And as indicated above, Gujarat is not one of the preferred destinations for medical tourists, the latter preferring the cities of Chennai, Delhi, Mumbai or even Bangalore. So, today, Gujarat is a State specialized in a very specific field of medical tourism, that is surrogacy. So, through the example of India, this article aims first to show how the reproductive tourism geography obeys a different logic from that of medical tourism. From the example of surrogacy, it will then propose an inventory of this practice in India and an assessment of the impact on the areas concerned, with particular reference to infrastructure development of health and tourist amenities.
