EU Commissioner Olivér Várhelyi underlined that the European Union is accelerating reforms to strengthen health sovereignty and resilience, from new pharmaceutical rules to faster pathways from innovation to treatment. Yet beyond regulation and innovation, one fundamental shift stood out — Europe must move from treatment to prevention.

This shift is not theoretical. It reflects a growing consensus that future health systems must prioritise early intervention, mental health, and long-term resilience. In this context, prevention is no longer optional — it is becoming the backbone of Europe’s health strategy.

A New Health Vision: Prevention, Early Intervention, and Wellbeing

Across discussions at the Summit, experts emphasised the urgent need to reach high-risk groups earlier through awareness, education, and preventive action. Health systems must evolve to support healthier lifestyles, longer lives, and stronger communities.

This direction aligns closely with the development of new initiatives in the health tourism and spa sector, which aim to:

• promote healthy lifestyle behaviours among both residents and travellers,
• develop destinations that actively support preventive health,
• integrate spa medicine, mineral water therapies, and nature-based treatments,
• and create tourism products that encourage longevity and quality of life.

Such approaches reflect a broader transformation already recognised within Europe’s health landscape: nature-based, evidence-driven prevention is becoming a key pillar of modern healthcare.

Shared Challenges, Collective Solution

The Summit also highlighted that Europe’s health challenges cannot be addressed in isolation. WHO Director-General Dr. Tedros Adhanom Ghebreyesus stressed that today’s threats — from chronic diseases and mental health issues to displacement and poverty — require stronger cross-border cooperation.

This perspective reinforces the importance of transnational networks and shared knowledge. In this context, European health destinations and spa networks represent practical models of collaboration, offering non-pharmaceutical, cross-border solutions for prevention and rehabilitation.

At the same time, the European Public Health Alliance (EPHA) delivered a stark warning:
if health systems fail, all other systems follow. Health is no longer just a social issue — it is a strategic asset for Europe’s stability and future.

Mental Health: Europe’s Growing Concern

One of the most urgent topics raised during the Summit was the rapid deterioration of mental health, particularly among younger generations. Policymakers called for immediate and coordinated action, recognising that a healthy population is the foundation of societal resilience.

Here, nature-based therapies — including climate therapy, forest bathing, and spa environments — are increasingly recognised as effective tools to support mental wellbeing. These approaches demonstrate how natural resources can complement traditional healthcare systems, offering accessible and preventive solutions.

The Strategic Role of Health Tourism and Natural Therapies

As Europe faces rising pressure on healthcare systems, new models of care are gaining importance. Prevention, healthy ageing, and resilience are no longer abstract goals — they are practical necessities.

Health tourism and spa-based interventions can play a key role by:

• reducing the burden on hospitals through preventive care,
• supporting rehabilitation and long-term health management,
• decentralising health services across regions,
• and empowering SMEs to deliver high-quality, sustainable health services.

This reflects a broader reality already highlighted in European spa research and policy discussions: medical spas and health destinations are not a luxury, but part of Europe’s health infrastructure .

A Strategic Moment for Europe — and for ESPA

The Euronews Health Summit confirms a decisive shift in Europe’s health priorities. The future will be shaped by:

• prevention,
• healthy ageing,
• mental health support,
• resilience,
• cross-border cooperation,
• and nature-based solutions.

These priorities strongly align with the long-standing mission of the European Spas Association (ESPA), which promotes nature-based prevention, mental wellbeing, and accessible health tourism ecosystems.

Looking Ahead: From Opportunity to Action

Europe now stands at a turning point. The question is no longer whether health systems need to change — but how quickly this transformation can happen.

In this new landscape, organisations and sectors that already deliver preventive, evidence-based, and sustainable health solutions have a unique opportunity to contribute.

More information: https://www.euronews.com/health/2026/03/17/the-biggest-challenge-and-opportunity-euronews-health-summit-key-takeaways

Mr. Petr Kulhánek, Former Minister for Regional Development, Czech Republic and Former Mayor and Regional Leader of Karlovy Vary

Mr. Kulhánek brings extensive experience in regional policy, tourism development, and public administration, providing valuable insight into the integration of spa and health tourism into sustainable regional strategies.

Dr. Reza Soltani, President of the Tourism Industry Research Centre, Partner of Woman Wellbeing project
Dr. Soltani is a globally recognized expert in tourism research, innovation, and strategic development, contributing deep knowledge of industry trends and evidence-based evaluation.

Their expertise will strengthen the jury’s ability to recognize excellence in health tourism, spa innovation, and sustainable wellbeing initiatives across Europe.

We look forward to their contributions in selecting the next generation of award-winning health destinations and spa leaders.

More information about the awards: https://europeanspas.eu/espa-innovation-award/

On 12 May 2026, the ESPA Thalasso Working Group will convene in Varna, Bulgaria – a distinguished Thalasso destination on the Black Sea coast.

The working group, initiated by Marlies Sobczak (ESPA Board Member, NL) and supported by Wilhelm Loth (Director, Staatsbad Norderney, DE), brings together European experts committed to strengthening the scientific foundation, visibility, and sustainable and economic development of Thalasso in Europe. The meeting is part of the HealthXchange Summit 2026, organized by European Spas Association, the Bulgarian national association BUBSPA, HTI and other partners, bringing together European spa and health tourism stakeholders. This ESPA meeting will be chaired by the newly elected President, Assoc. Prof. Dr. Siyka Katsarova.

PART I.: Thalasso Exchange  
12 May 2026 from 14.00 to 15.30 – LIVE SESSION

The Thalasso meeting will begin with a high-level expert knowledge exchange, followed by an interactive online workshop open to additional interested stakeholders from participating European countries.

The overarching theme is: “The Health of the Sea”
Recognising that the health of people and the health of marine ecosystems are inseparably connected. Thalasso: the importance for our economy and natural environment

Part I – Expert Knowledge Exchange (On-site, Varna)

Title: Science, Practice and Policy in Dialogue
The meeting will open with an expert conversation featuring leading European voices in Thalassotherapy and thermal medicine:

• Prof. Dr. Todorka Kostadinova – Medical University of Varna (Bulgaria)
• Dr. Marina Lalli – President, Federterme (Italy)
• Dr. Marie Perez Siscar – President, French Thalasso Organisation (France) On line
• Prof. Maria Lourdes Mourelle – Author and Lecturer in Thalassotherapy, University of Vigo (Spain)
• Claudia Wagner Managing Director, Fit Reisen (Germany)
• Wilhelm Loth Director Staatsbad Norderney (Germany)

The session will be structured as a moderated dialogue, encouraging interaction between health science, practice, tourism development and European cooperation.

Part II Online workshop
13 May 2026 from 14.00 to 15.30

During the online workshop, Thalasso in theory and practice will take centre stage including contributions from different countries.

Dr. Michele Antonelli, World Hydrothermal Organization (OMTh), Italy: This intervention aims to explore the impact of marine environments on human health, focusing on the physiological and psychological benefits of sea climate, air quality, and exposure to marine elements. The presentation highlights current scientific evidence on thalassotherapy, examining its role in prevention, rehabilitation, and wellbeing. It also discusses emerging research on how coastal ecosystems and marine resources can support integrative, evidence-based approaches to health promotion.

Mr. Serge Fourcade, Quality Director of the Thalazur group, France
Experience the Epigenetic Journey
Epigenetic science has shown the influence of the environment on gene expression and our overall health.It’s possible to take action at any age to preserve your health!
Our thalassotherapy centers will guide each client in improving their lifestyle using the 5 pillars of epigenetics: Mindful nutrition, personalized physical activity, stress management, a supportive social environment and the pleasure of linving. Become an Actor in Your Health!

Ms. Anja Raschke, SPA and Thalasso Coordinator at Staatsbad Nordeney, Germany:
From Concept to Impact: Thalassotherapy Best Practice at bade:haus Norderney
A review of how we have holistically integrated the concept into practical implementation within our facility: treatments, Thalasso offers, courses, sauna rituals, and lounge areas.

Attendance at the online workshop is free of charge. Please fill-out the Registration form to receive the link to the online platform.

For more information please contact: thalasso@europeanspas.eu

Monday, May 11

Hosted Buyers Study Tour
19:30 Welcome Dinner | Venue: Hotel NOA, Golden Sands Resort

Tuesday, May 12

Congress Program: 08:30 – 17:30
Venue: Hotel NOA, Golden Sands Resort

Morning Plenary – Vision, Policy & Scientific Foundations for Sustainable Health Tourism

08:30 – 09:00 | Registration & Welcome Coffe
09:00 – 09:10 | Opening Session

Opening Remarks – Organisers & Hosts
A welcome address introducing the mission of the HEALTHXCHANGE Summit

• integrating health, tourism, science, and sustainability into a unified European vision,
• positioning health tourism as a driver of prevention, resilience, and regional development,
• and setting the tone for a day of evidence‑based, cross‑sector collaboration.

09:10 – 09:25 | Keynote Address
Minister of Tourism (TBC): “National Vision for Sustainable Health Tourism”
A strategic overview of:

• national priorities for health tourism and wellbeing,
• investment pathways supporting sustainable and resilient destinations,
• the role of health tourism in long‑term economic, social, and territorial cohesion,
• and opportunities for innovation in prevention, longevity, and nature‑based health services.

09:25 – 09:35 | Keynote Address
President of the ESPA and BubSpa: Assoc.Prof. Dr Siyka Katsarova
A visionary welcome highlighting:

• the purpose and ambition of the HEALTHXCHANGE Summit,
• Europe’s unique strengths in natural remedies, spa medicine, and climate health,
• and the need for a unified European narrative connecting science, tourism, and public health.

09:35 – 11:00 | EU Delegates Session

EU Perspectives, Policies & Cooperation Opportunities for Health and Health Tourism
A high‑level panel featuring representatives from EU institutions, exploring:

• synergies between EU health and tourism policies,
• state aid frameworks and recovery mechanisms,
• cross‑border cooperation in prevention, longevity, and natural remedies,
• integration of health tourism into EU strategic agendas (Green Deal, Digital Europe, EU4Health),
• and the role of evidence, research, and social data in shaping sustainable health ecosystems.

 Speaker: Ass. Prof. Dr. Milena Angelova
Member, European Economic and Social Committee (EESC)
President, ACP–EU Follow‑up Committee
Rapporteur of the EU Life Sciences Strategy

Focus:

• The role of life sciences in prevention and health tourism
• EESC perspectives on sustainable health ecosystems
• Opportunities for social partners in health tourism development

Mr. Petr Kulhánek
Former Minister for Regional Development, Czech Republic
Former Mayor and Regional Leader of Karlovy Vary

Key architect behind:

• the CZK 1 billion (€38 million) EU‑approved State Aid Scheme supporting medical spas and rehabilitation providers during COVID‑19 (approved under Article 107(3)(b) TFEU),
• the establishment of the Karlovy Vary Spa & Balneology Research Centre.

Focus:

• Lessons from the Czech spa support scheme
• Evidence of economic and health impact
• How research centres strengthen Europe’s balneology leadership

Mr. Ivaylo Kalfin (TBC)
Executive Director, EUROFOUND
Former Member of the European Parliament

Leader of the Eurofound study on voucher systems in medical spas and their economic & health effects post‑COVID.

Focus:

• Findings from the EU‑wide spa voucher impact study
• Implications for national and EU‑level prevention strategies
• How labour market and social data support the health tourism sector

Mrs Tilly Metz (Invited)
Member of the European Parliament (Luxembourg)
ENVI Committee • TRAN Committee

Focus:

• The European Parliament’s role in shaping prevention, public health, and sustainable tourism
• Integrating natural remedies and spa medicine into EU health promotion frameworks

Mr. László Andrejko (Invited)
Representative of the European Commission – Health and Animal welfare 

Topic:
“Cardiovascular Health Action Plan: Opportunities for Prevention Through Natural Remedies and Spa Medicine”
A contribution linking EU cardiovascular strategies with nature‑based, balneological, and lifestyle interventions.

Mrs. Victoria Petrova (Invited)
Senior Expert, MOVE.A5 Tourism, European Commission
DG MOVE – Sustainable Transport & Tourism

Focus:

• European tourism policy for sustainable and resilient tourism ecosystems
• Guidance for stakeholders across Europe

Mrs. Anja Fortuna (Invited)
Policy Analyst, Rural Pact Support Office (RPSO)

Focus:

• How the Rural Pact amplifies rural voices and elevates them on the political agenda
• Opportunities for rural regions in health tourism, wellbeing services, and spa‑based revitalisation
• Synergies between the Rural Pact community and Europe’s health, spa, and longevity destinations
• Pathways for collaboration, good practice exchange, and community‑driven innovation

11:00 – 11:30 | Coffee/mineral water Break

11:30 – 12:30 | ESPA Forum The Science of Balneology – Where Health Tourism and Public Health Meet
A scientific session curated by ESPA, presenting

Parallel Programme:

10:00 – 16:00: HEALTHXCHANGE B2B Session
(Note: This will run parallel to the congress program at the same venue.)

Afternoon Programme – Innovation, Water, Climate & Industry Leadership

12:30 – 14:00 | Networking Lunch

A curated networking lunch featuring regional products and opportunities for informal dialogue among policymakers, researchers, spa operators, and industry leaders.
Focus on building cross‑sector partnerships and exploring collaborative projects.

14:00 – 14:30 | Fireside Chat – Healing Water as a Strategic Resource

Speakers:

• Representatives from the Bled Water Forum
• Expert contributor to the European Water Strategy

Themes

Water as a strategic natural asset for health, tourism, and climate resilience
The role of mineral and thermal waters in prevention, wellbeing, and medical spa services
Water governance, sustainability, and protection of Europe’s hydro‑mineral heritage
How water‑rich regions can position themselves as leaders in health tourism and longevity
A conversational, insight‑driven dialogue connecting science, policy, and destination development.

14:30 – 15:30 | Health Tourism Industry Forum

A dynamic industry session bringing together operators, investors, and national associations to discuss:

• market trends in prevention, longevity, and wellness travel
• digitalisation and personalised health tourism services
• workforce development and skills for the future
• investment opportunities and public–private partnerships
• the role of certification, quality standards, and evidence‑based practice

This forum highlights Europe’s competitive advantages and the need for coordinated industry action.

15:30-16:00 Coffee/mineral water Break

16:00 – 17:00 | Bulgarian Spas & Balneology Forum

A dedicated spotlight on Bulgaria’s leadership in spa medicine, balneology, and health tourism.
Topics include:

• Bulgaria’s natural resources and therapeutic traditions
• National strategies for spa modernisation and sustainable destination development
• Integration of balneology into public health and prevention programmes
• Opportunities for cross‑border cooperation and EU‑funded projects

Featuring leading Bulgarian experts, operators, and policymakers.

17:00 – 17:30 | Fireside Chat – Climate & the Healing Climate

Speakers:

• Representative from DG CLIMA – Directorate‑General for Climate Action
• Publisher of The Healing Climate, recipient of last year’s Innovation Award Jury Prize

Themes:

• Climate as a determinant of health and a core asset for health tourism
• How climate‑sensitive destinations can adapt and thrive
• The science behind “healing climates” and their therapeutic value
• Climate policy, sustainability, and the future of nature‑based health services
• Innovation pathways linking climate action, tourism, and public health

A forward‑looking dialogue bridging climate science, policy, and destination innovation.

19:00 – 19:30 Pre-gala Welcome Drink | Venue: Aquahouse Thermal & Beach, St. St. Constantine and Helena Resort

20:00 – ESPA Innovation Award Gala Dinner | Venue: Astor Garden Hotel, St. St. Constantine and Helena Resort

Wednesday, May 13

10:00 – 13:00: Longevity Forum | Venue: Ensana Aquahouse Hotel & SPA, St. St. Constantine and Helena Resort

Mrs. Nikolina Angelkova – Former Minister of Tourism of Bulgaria (2014-2017), Investment Advisor, and Lawyer. Topic: Integration of the longevity concept in DMOs’ and brands’ strategies.

Mrs. Vesela Toncheva-Schenk – Certified Longevity Fitness Coach (Bulgaria-Germany).

13:00: Site Visits

The Municipality of Varna is located in northeastern Bulgaria, the administrative center of Varna region, with a population of more than 330,000 people. Varna is the third-largest city in Bulgaria – recognized as the maritime capital of the country, combining sea charm, rich cultural heritage, and modern urban life.

Varna region, with its 32 km of coastline, is known for its favorable climate, natural resources, and the sea, which creates excellent conditions for tourism and balneotherapy within the four seasons. In 2026, Varna will celebrate the 105th anniversary of its designation as a seaside resort.

HeathXchange Summit 2026 will be held from 11 – 13 May 2026. Read more….

The advantage of the region is that, in addition to its luxurious infrastructure, it also boasts a wide range of specialists trained at the internationally recognized Medical University of Varna in the field of “Rehabilitation, Thalassotherapy, Wellness, and SPA” – a program designed to meet the rapidly growing needs of the healing and wellness markets in Bulgaria and the specific demand for highly qualified professionals in the sector.
There are a total of 25 certified centers in Varna:

• Balneotherapy (Medical SPA) – 8
• SPA – 10
• Wellness – 7

Varna is a city where the sea and mineral water come together in a unique way. As Bulgaria’s third-largest city and the major tourist center of the Black Sea coast, Varna combines 7,000 years of history with a modern lifestyle. Sea, nature, culture, and well-being have merged here into a harmonious overall experience.

Even in ancient times, the healing power of mineral water were combined here with physical activity and regeneration. This tradition still forms the basis of the region’s balneological culture today.

Varna is considered one of the richest regions in Bulgaria in terms of water resources. The calcium-magnesium-rich, lightly mineralized thermal waters with temperatures between 40 and 60°C are ideal for prevention, therapy, and sustainable recovery. Traditionally, these thermal waters are used to support treatment of cardiovascular diseases, disorders of the endocrine system, the musculoskeletal system, as well as functional disorders of the nervous system.

Varna offers first-class SPA and wellness infrastructure with more than 25 certified SPA, wellness, and balneotherapy centers. In the renowned SPA resorts of St. Constantine and Helena, Sunny Day, Golden Sands, and Riviera, modern SPA and balneological centers offer a variety of health and relaxation programs based on natural healing resources. Coastal thermal pools and elegant water facilities connect the regenerative power of thermal springs with the freshness and vastness of the Black Sea.

Tourists can benefit from a wide variety of regenerative treatments in the rehabilitation centers:

• Detox programs: using eastern practices, massages, and natural detoxifying products such as algae, herbs, and Black Sea salts;
• Mud therapies: relieve joint and muscle pain and activate metabolism;
• Rebalance programs: combines immersion in mineral water with guided physiotherapy exercises;
• Healing massages with magnesium oil: relieve muscle tension and promote blood circulation;
• Therapies with natural ingredients: grape cures and wine therapies, as well as treatments with honey, yogurt, and essential oils, specifically promote health and beauty and support natural regeneration processes;
• Individually tailored wellness and health programs: customized treatments for sustainable reduction of stress and exhaustion, strengthening the immune system, and enhancing overall well-being.

Varna – an accesible destination for recreation and exciting experiences

Varna`s excellent accessibility is ensured by a well-developed, multimodal transport network, integrating railway and bus terminals, as well as efficient road connections linking the airport with the city and the nearby seaside resorts.

The railway station
The Varna Railway Station is among the first railway stations built in Bulgaria, dating back to 1866.

Varna airport
Varna Airport is located just 8 km of the city centre. It facilitates convenient access for hundreds of thousands of visitors to Varna and its resorts, while offering high-quality services. Varna Airport welcomes tourists year-round, thanks to the expanded and optimized flight schedules of a number of airlines—there are year-round flights to five cities in Germany, Tel Aviv, Istanbul, Vienna, Brussels, London, Eindhoven, Bergamo, as well as multiple daily flights to the capital Sofia.

Port Varna
Port Varna East is located in the Bay of Varna, only 1 km from the city’s central area. The largest port in Bulgaria and the country’s maritime gateway to the world.

The bus station

The new Varna bus station was officially opened on 1 June 2024. The building features a modern design and high functionality, with 12 departure sectors, 30 bus parking spaces, as well as a 24-hour waiting area and an on-site food and beverage establishment.

Varna Resorts

In and around Varna are some of the most beautiful beaches in Bulgaria — expansive stretches of golden sand, refreshing greenery, crystal-clear sea waters, and a rich variety of seaside resorts, recreation zones, and places dedicated to relaxation and recovery.

In the 1950s and 1960s, the seaside resorts of Sts. Constantine and Helena and Golden Sands were developed in their modern form. The magnificent beaches and contemporary hotels have since attracted visitors from all over the world. In 2025, Bulgarian recipients of the prestigious Blue Flag international award rank among the world’s best beaches and marinas. Among them are the beaches of the Golden Sands and Sunny Day resorts.

The resorts “Saints Constantine and Helena“, “Sunny Day“, “Golden Sands“, and “Riviera” offer unique opportunities to combine the sea breeze with the healing power of the mineral water. The pools and water facilities located along the coast combine the benefits of sea water and climate with those of thermal springs. In modern SPA centers, you can enjoy a variety of cosmetic and medical treatments using another natural resource – the mud from the lagoon.

Sts. Constantine and Helena

Bulgaria’s first seaside resort, Sts. Constantine and Helena, has been known for more than a century for its beautiful coastal scenery and unspoilt natural surroundings. Today, it continues to attract visitors with its picturesque shoreline, cosy beaches, and clean air. Enriched by the healing power of the sea and the mineral springs found throughout the resort, it offers health, vitality, and well – being.

Golden Sands

A modern resort with more than 65 years of history and tradition. Located 16 km north of Varna, Bulgaria’s maritime capital, it is nestled within the cool forest of the nature park bearing the same name and lies just steps away from its iconic golden sandy beach. One of the resort’s greatest assets is its abundance of healing mineral springs.

Organised by Health Tourism Industry (HTI) under the leadership of Ivana Kolar and hosted by MEP Nikolina Brnjac, the summit brought together policymakers, tourism leaders and healthcare experts to discuss how Europe can position itself as a global leader in health and wellbeing.

A sector gaining political momentum

Opening the summit, Ivana Kolar described health tourism as a broad and rapidly evolving field, covering “general spa, prevention, rehabilitation, medical” services.

Kolar stressed that the sector sits at the intersection of public policy and private investment, noting that HTI provides “a unique platform that connects policymakers, destinations, health providers, facilitators, investors, and industry associations”.

MEP Nikolina Brnjac framed the discussion in a wider European context, arguing that health tourism must become a central component of Europe’s future. “I strongly believe that health tourism is an important driver of tourism sustainability,” she said, adding that it is also “a crucial ingredient in the new branding of destination Europe”.

She highlighted growing pressures from ageing populations, climate change and geopolitical uncertainty, noting that “at the very core of health tourism is the contribution to physical, mental and spiritual health”.

Brnjac also pointed to the economic dimension of the sector. “Health tourists spend around eight to ten times more than other tourists,” she said, calling for harmonised European standards and increased investment.

Europe’s competitive edge in wellbeing tourism

Eduardo Santander, CEO of the European Travel Commission, emphasised that health and wellbeing tourism is no longer a niche trend but a structural shift in travel behaviour.

“It’s here to stay,” he said, pointing to the growing demand for wellness-focused experiences and quality of life.

Santander argued that Europe already has the foundations to lead globally, thanks to its diversity, cultural heritage and long-standing wellness traditions. He also stressed that tourism must evolve beyond recovery towards what he described as “smart growth”.

“We have to start thinking about tourism as not an extraction form of industry but one that is investing, especially in its people,” he said.

At the same time, he highlighted the importance of cooperation between destinations. “If we work together to position Europe as a shared destination for wellbeing tourism, we all will win.”

Preventive health and spa medicine under the spotlight

A central moment of the summit came with the intervention of Siyka Katsarova, President of the European Spas Association, who called preventive health and spa medicine one of Europe’s most underutilised assets.

Referring to the Covid-19 period, she noted that citizens increasingly turned to natural and preventive solutions. “People were just looking for solutions to improve healthcare,” she said.

Katsarova argued that health tourism can help tackle one of Europe’s structural tourism challenges: seasonality. Countries such as Croatia, Greece, Spain and Italy could benefit from more year-round health-focused offers.

Crucially, she insisted that health tourism must be treated as a cross-sector priority. “Health tourism is sitting in between two main industries,” she said, referring to tourism and healthcare.

She also warned that Europe risks falling behind global competitors. “Europe is sleeping,” she said, urging policymakers to better leverage the continent’s “natural healing resources” and adopt a more holistic approach to health.

According to Katsarova, the sector already represents a significant economic force, with more than 1,400 certified medical spas, over 850,000 jobs, 25 million annual visitors and a €50 billion impact.

“One euro investment in prevention is saving seven euros from healthcare,” she added, making the case for stronger policy support.

Cross-border healthcare is still too complex

MEP Tomislav Sokol addressed the legal framework governing cross-border healthcare, warning that existing EU rules remain too complicated for most patients.“These legal rules are so complicated that you need to be a health law expert to know what your rights are,” he said, describing the current system as “a mess”.

While EU legislation allows patients to seek treatment abroad under certain conditions, Sokol said that overlapping rules, administrative barriers and lack of awareness prevent the system from functioning effectively. He called for simplification, better information for patients and the creation of structured cross-border healthcare pathways, including centres of excellence serving multiple countries.

The reality for patients on the ground

Michal Dybowski, President of the Healthcare Poland Foundation, brought a practical perspective, highlighting the gap between legislation and real-life patient experience.

“We don’t have a problem with our law because the law is good. But we have a serious problem with how we really execute them,” he said.

Through a series of case studies, he illustrated how patients face obstacles such as lack of reimbursement, poor transfer of medical records and long administrative delays. Among the most striking figures he cited was the average waiting time for reimbursement approval. “531 days,” he said.

Dybowski also pointed to the absence of common quality standards for medical providers, limited patient information and the lack of coordinated visa policies for medical travel.

Despite these challenges, he insisted that solutions are within reach, including digital tools, shared standards and the future European Health Data Space.

“It’s not utopia. We’ve got to build it,” he said.

A window of opportunity for Europe

Across the summit, a clear message emerged: Europe has all the ingredients to lead in health tourism, but lacks the coordination and political prioritisation needed to unlock its full potential.

With a European strategy for sustainable tourism expected in the coming months, stakeholders see a crucial opportunity to integrate prevention, wellbeing and cross-border healthcare into the EU agenda.

As discussions continue in Brussels, health tourism is increasingly being recognised not as a niche, but as a strategic asset for Europe’s competitiveness, resilience and quality of life.

Author: António Buscardini

Source: https://traveltomorrow.com/calls-grow-for-eu-wide-standards-in-health-tourism-and-cross-border-care/

Additional information about the event: https://www.europarl.europa.eu/news/ro/press-room/20260316IPR38220/meps-advocate-for-smart-management-of-tourism

As ITB celebrated its 60th anniversary, the Medical & Health Tourism Pavilion in Hall 4.1 was bigger and more impactful than ever. The European Spas Association was proud to co-create this year’s programme, highlighting the future of evidence-based health tourism, from longevity and regenerative medicine to the healing power of Europe’s traditional thermal waters.

Throughout the event, the pavilion became a dynamic hub for policy discussions, expert panels, networking, and industry exchange, bringing together leading voices from tourism, healthcare, research, and public institutions. Our members from Bulgaria, Croatia, the Czech Republic, Georgia, Germany, Italy, Hungary, Lithuania, Slovenia,  Slovakia, and Romania made the presentation of medical spas perfect. Thank you very much for the contributions! 

ITB Health Destination Award 2026

A special moment during ITB Berlin was the presentation of the ITB Health Destination Award 2026, which was proudly awarded to Italy, represented by Federterme and ENIT.

Italy was recognised for:

• Europe’s largest investments in spa and wellbeing infrastructure, European Spas Innovativation Award winner De Montel thermal spa in Milan is a new milestone in Europes spa world.
• Strong scientific research in balneology through collaboration with universities and the FORST Foundation
• The development of Italcares, a global platform promoting Italian healthcare and thermal medicine 

Italy demonstrates how health tourism can successfully combine medical evidence, cultural heritage, sustainability, and global competitiveness.

Congratulations to Visit Düsseldorf for being awarded the best Medical Tourism Destination 2026! Thank you to all jury members for your valuable work and cooperation; special thanks to ITB!

Strategic Partnership for Women’s Wellbeing

A major highlight of ITB Berlin 2026 was the launch of a strategic collaboration between the Institute of Tourism and the European Spas Association (ESPA) focused on women’s empowerment and wellbeing.

This partnership aims to expand access to evidence-based natural healing services, promote preventive health, and strengthen women’s role in the tourism and health sectors.

The collaboration was focused on:

• Promoting women’s health and preventive wellbeing through spa medicine and natural healing services
• Developing research, studies, and policy recommendations on women’s empowerment
• Supporting female professionals, entrepreneurs, and leaders in tourism and healthcare
• Creating programmes encouraging healthy lifestyles, resilience, and self-care
• Strengthening cooperation with governments and international organisations

A Joint Working Group will soon be established to develop research initiatives and pilot projects that place women’s wellbeing at the centre of sustainable tourism and health strategies.

Dialogue with UN Tourism

During ITB Berlin, the European Spas delegation also held an important meeting with Cordula Wohlmuth, Regional Director Europe of UN Tourism. Discussions focused on strengthening cooperation and expanding knowledge transfer and publications on health tourism within the UN Tourism framework.

There was strong interest in further collaboration on topics such as:

• Quality standards for health destinations
• Health tourism as a driver of sustainable tourism development
• The growing importance of the Silver Economy

At the Global Tourism Summit at the Ritz-Carlton, European Spas representatives also had the opportunity to exchange perspectives with UN Tourism Secretary-General Shaikha Al Nuwais, exploring opportunities to further highlight health tourism and longevity-focused travel at a global level.

Healthy Water Initiative – A Unique Experience

One of the most engaging highlights at the European Spas stand was the “Healthy European Waters” Bar. This interactive concept allowed visitors to experience the diversity and therapeutic qualities of Europe’s mineral waters, sparking inspiring conversations about water as a cornerstone of health and spa medicine.

The initiative was organised in cooperation with the Slovenian Spas Association and the Slovenian Tourist Board, showcasing the strength of European collaboration in health tourism.

Academic Cooperation and Young Talent

European Spas was delighted to welcome Prof. Waldemar Berg, President of the Deggendorf Institute of Technology, for valuable discussions on future academic cooperation.

Special thanks go to our members and colleagues Anke Sponer and George Christian Steckenbauer, whose expertise and contributions to the Medical & Health Tourism Pavilion stage programme were instrumental to the success of our presence at ITB Berlin 2026.

We are also deeply grateful to the students from Deggendorf Institute of Technology, whose energy, professionalism, and creativity helped represent the European Spas Association throughout the entire trade fair. Their engagement truly reflects the future of our sector.

Inspiring Discussions at the Pavilion

The pavilion programme featured numerous high-level discussions, including:

Longevity, Regeneration & Prevention – Beyond the Buzzwords
with leading experts discussing the transformation of preventive healthcare.

Digitalisation in Health Tourism,
exploring education and innovation in cooperation with international partners.

Wellbeing in Tourism – Economic Engine: Impact Today, Value Tomorrow,
highlighting the growing economic importance of health and wellness tourism.

Looking Ahead

ITB Berlin 2026 once again confirmed that health tourism is becoming one of the most dynamic sectors in global travel.

The European Spas Association remains committed to strengthening spa medicine, preventive health, sustainability, and innovation, while building international partnerships that support healthier societies and thriving tourism regions.

Thank you to Thomas Böhmkes, Ophelia Janik and to all our partners for the intensive and successful days!

Set deep within the pine forests of Dzūkija, Aukštoji Liškiava SPA Resort is redefining what a modern wellness destination can be. In conversation with ESPA Magazine, Eglė Rukšenaitė, founder of E77, shares the philosophy, nature-led design, and future-forward vision behind this extraordinary spa retreat.

Q1: You integrate forest therapy, climate therapy, water, and local traditions. Which element has had the most unexpected impact on guests?

Eglė Rukšenaitė:
What surprises our guests most is how deeply restorative true wilderness can be—when it is thoughtfully integrated with modern comfort. Many arrive wondering if such simplicity can really feel luxurious. And then they find themselves bathing beneath a natural waterfall, swimming outdoors at –20°C, or walking forest paths between treatments and dinner, surrounded only by silence and pine-scented air. In addition, discrete five-star service is what unites all mentioned factors into one.

We are witnessing a global shift. Overcrowded spa resorts and oversized wellness complexes are losing emotional value, particularly for Millennials and Gen Z. Today’s modern, well-informed guests seek authenticity, silence, and meaningful immersion in nature—without compromising comfort or quality.

Guests experience the forest without disturbing it, supported by a full spectrum of spa and medical wellness treatments. The forest and water together create a level of immersion that goes far beyond conventional spa experiences.

At Aukštoji Liškiava, we have created a rare balance: preserving the forest’s raw integrity while offering a complete spa and medical wellness experience. From hydrotherapy and underwater massage to detox wraps and mental health-focused meditation, everything exists within nature rather than apart from it. This is not escapism—it is reconnection.

Q2: What natural healing resources do you highlight, and how do they reflect the character of Dzūkija?

Eglė:
Dzūkija is one of Europe’s greenest and purest regions. Endless pine forests—stretching nearly 100 kilometers—create a unique climate therapy environment, rich in oxygen and essential oils. Clean air here is not a luxury; it is a treatment in itself.

Water is equally essential. The region offers exceptionally clean rivers, lakes, springs, and streams, all integrated into our wellness concept. Guests experience organised bathing under natural waterfalls, therapeutic water tubs, and hydrotherapy rituals rooted in local tradition.

The land is also abundant in medicinal plants and herbs, which form the foundation of our spa menu. These resources are used both directly and through professional, eco-certified spa formulations, ensuring safety, efficacy, and authenticity.

Key elements include:

• Seaweed and algae: mineral-rich, antioxidant ingredients supporting detoxification and skin vitality
• Plant-based actives: shea butter, evening primrose oil, sweet almond oil, honey, wheat germ oil—selected for purity and performance
• Forest herbs and moss extracts: local flora embodying Dzūkija’s healing character
• Natural waterfall: an active hydrotherapy element for revitalisation and resilience
• Forest sauna with authentic Lithuanian rituals: moss, algae, and herbal steam therapies delivering gentle mineral warmth

Together, these elements form what we call the Mystical Forest Journey—a holistic experience rooted in place, tradition, and modern wellness science.

Q3: How have Lithuanian wellness traditions shaped your rituals and experiences?

Eglė:
Lithuanian wellness culture has always been deeply connected to nature. At the resort, we revived this philosophy by designing separate buildings for different functions, connected by wild forest paths. Guests walk through nature—from hotel to spa, spa to restaurant, restaurant to sauna—allowing movement, fresh air, and rhythm to become part of the therapy.

We have also integrated long-standing Lithuanian spa rituals, including:

• Moss and leaf rituals: used in steam, water treatments, and even culinary applications
• Herbal infusions and steam therapies: guided by seasonal cycles
• Traditional sauna rites: inspired by Baltic barn and smoke sauna traditions
• Water-based rituals: including cold river immersion and waterfall exposure, adapted to seasonal conditions

These practices are not staged performances—they are living traditions, carefully adapted for contemporary guests.

Q4: Climate therapy is central to your concept. How do you work with it intentionally?

Eglė:
The future of wellness is simple: less structure, more nature. Time spent outdoors—truly outdoors—is becoming one of the most powerful healing tools. Many luxury resorts struggle with this because everything happens under one roof.

In Dzūkija, the climate does the work for us. Crisp air, seasonal shifts, forest microclimates—all gently guide the body back into balance. We design programs that follow these natural rhythms, combining sauna heat with outdoor cold exposure, and creating quiet, protected outdoor spaces for rest and reflection. The result is a deeply restorative, climate-informed wellness experience.

Q5: How does the secluded forest location influence guest outcomes?

Eglė:
The setting is not a backdrop—it is a therapeutic partner. The forest quiets the nervous system, sharpens awareness, and invites presence. Guests sleep better, breathe deeper, and reconnect with their own rhythms.

The remoteness naturally encourages digital detox. Without distraction, people rediscover hunger, rest, and stillness. This reconnection is essential for sustainable wellbeing—and it is something no urban spa can truly replicate.

Q6: What differentiates Aukštoji Liškiava from other wellness destinations?

Eglė:
Perhaps the boldest part was choosing to build something so intimate and investment-heavy (over €8 million) in a remote, protected landscape. It goes against conventional logic. Yet this “unusual” choice reflects the future of wellness.

What makes us different is the synthesis: forest energy, water therapy, climate, ritual, architecture, gastronomy, and medical wellness are woven into one coherent journey. At first glance, these elements may seem unlikely together—but this is exactly what the future wellness guest is seeking.

Q7: Is there a guest moment that captures your vision?

Eglė:
Many guests struggle to put it into words. They describe a “spiritual effect”—a sense of calm, clarity, and restored energy they didn’t expect. In professional terms, it is holistic balance: the alignment of body, mind, and environment. When people leave feeling lighter, clearer, and quietly transformed, we know the forest has done its work. Even guests who do not consciously seek mindfulness experience its effects naturally—through forest walks, silence, water, and rhythm. Sleep improves. Stress softens. Something real resets.

Q8: How does architecture support the experience?

Eglė:
Designing a wellness resort like this is an art. Architecture follows the landscape, not the other way around. Buildings reflect Dzūkija’s ethnographic character, materials are natural and local, and pathways weave through grass, snow, and forest floor.

Even small decisions matter. There are no traditional terraces—guests step directly onto earth. You feel the ground, the season, the place. The boundaries between indoors and outdoors dissolve, allowing nature to remain present at every moment.

Q9: What would you like ESPA readers to take away?

Eglė:
Be ready for a new era of wellness. Aukštoji Liškiava represents a new benchmark for boutique medical and wellness spa resorts—rooted in natural resources, authenticity, and ecology, yet supported by high-quality infrastructure and expertise.

This is where the future is heading, especially for younger generations. Wellness is no longer about scale—it is about meaning. Here, timeless Lithuanian wisdom meets contemporary wellness science, creating a sanctuary that heals body, mind, and spirit in harmony with nature.

More information: https://aukstojiliskiava.lt/en/

ESPA has formal confirmed that Texel meets the criteria for a Thalasso Health Destination in accordance with the generally accepted European guidelines.

This means that Texel is officially recognized as a destination where health, well-being, and prevention are central, in line with the quality and health standards applied across Europe for Thalasso health regions. The recognition was preceded by various studies and assessments. Climatic conditions, as well as the salt content of both the seawater and the air, were taken into account.

Following the analysis, a medical balneological report was prepared, including preventive and therapeutic recommendations. These form the foundation for further development.

The recognition highlights, among other things:

• the quality of the natural environment on the seaside, clean air, tranquility, and open space),
• the range of health and wellness facilities,
• professional care and preventive services,
• and an integrated approach to vitality and recovery.

This makes Texel, along with Cadzand, Domburg, and Noordwijk, one of the four Dutch seaside resorts to receive this special recognition.

With this European recognition, the municipal executive is fulfilling one of the ambitions of the second Implementation Agenda for the Tourism Future Plan 2025-2027: conscious and worthwhile visits.

With a conscious and valuable offering, we cater to the Texel visitor who visits during the early and late season and highly values ​​the island’s core values ​​(peace, space, nature, scenic quality, cultural history, and darkness at night). This isn’t a new market, but rather a market deepening opportunity. This recognition aligns with Texel’s ambition to promote sustainable tourism.

Texel, naturally healthy: opportunities for the island and its visitors

Both the NBTC (Netherlands Board of Tourism and Conventions) and the Texel Tourist Information Office (VVV Texel) see significant opportunities to further enhance the island’s image under the banner “Texel, naturally healthy.” “We want to attract visitors who appreciate nature, tranquility, and quality,” says alderman Kieft. “The recognition confirms what we already knew: life on Texel is healthy. This unique designation helps us communicate this even more effectively to our residents, businesses, and everyone who comes here to recharge.”

The new theme page https://www.texel.net/en/see-and-do/texel-naturally-healthy/ showcases Texel’s significance as a healthy seaside resort. Visitors will find tips for experiencing health in an accessible, down-to-earth way. The page features recognizable labels that reflect what Texel already offers: outdoor exercise, active relaxation, mindfulness on Texel, local products, wellness on the island, and accommodations with wellness. These labels form the basis for existing and future activities, products, and packages that contribute to a healthy experience on the island.

For questions, please contact:
Rosalie Lap, Director of the Texel Tourist Office
T: +31 222 314741
E: r.lap@texel.net

Day 1 will present key outcomes of the Spa Research Centre project and host expert discussions on the future role of spa care, its position within the healthcare system, and opportunities for development through data, research, and interdisciplinary cooperation.

Day 2 will bring leading Czech and international specialists who will share current trends and best practices in spa treatment, balneology, rehabilitation, wellness, and preventive medicine.

The conference welcomes professionals from healthcare, spa services, research, public administration, and the private sector — offering a unique space for knowledge sharing, networking, and expert dialogue.

Find more information about the registration

Water tasting to learn about the healing effects of mineral water in cooperation with the Slovenian Spa Association and the Slovenian Tourism Board, Health tourism pavillon Stage Programme Hall 4.1

TUESDAY / 3th March
15:30 – 16:00 | Longevity, Regeneration & Prevention: Beyond the Buzzwords
Key themes: Regenerative medicine; Preventive healthcare. PANEL DISCUSSION
Panelists:
– Dr. Siyka Katsarova – President, BUBSPA & European Spas Association
– Marina Lalli – Vice President Federterme; President Federturismo; 
– Dr. Petra Bailey – Vice-President, Ensana Health Spa Group

Moderator:
Csilla Mezösi – Secretary General, European Spas Association

THURSDAY /5th March
11:00 – 11:30 | PRESENTATION

Digitalization in Health Tourism – Education in Cooperation with the World Health Organization
Presenter:
-Anke Sponer – International Cooperation, Deggendorf Technische Hochschule

11:30 – 12:30 | Wellbeing in Tourism – Economic Engine: Impact Today, Value Tomorrow; PANEL DISCUSSION
Panelists:
-Iuliana Tasie, Vice President of the European Spas Association and Optbr Romania; CEO ANA hotels Europa Eforie,  
-Lina Nosevič – Executive Director, National Association of Sanatoriums and Rehabilitation Institutions in Lithuania; mailto:lina@rehabilitation.lt
-Martin Plachy – CEO, Royal Spa CZ; Vice President, European Spas Association

Moderator:
Nikol Rashkova – European Spas Association

OTHER IMPRORANT presentations and programms:

TUE 3 MAR 12:00 – 12:15 OFFICIAL OPENING ITB MEDICAL & HEALTH TOURISM PAVILION 12:15 – 13:30 MEDICAL MEDIA NETWORKING LUNCH supported by Visit Bulgaria

15:00 – 15:30 EXPERT INTERVIEW with Daniel Attard;Member of the European Parliament (Malta), Committee on Transport and Tourism

EUROPE’S PATH TO SUSTAINABLE TOURISM GROWTH AND THE TRANSFORMATION OF EUROPE’S TOURISM REGIONS

17:00 – 19.00 ITB MEDICAL & HEALTH NETWORKING RECEPTION

WED 4 MAR, 19:00 – 22:00 ITB MEDICAL & HEALTH NIGHT 

presenting the ITB MEDICAL & HEALTH TOURISM AWARDS 2026

in partnership with European Spas Association (By invitation only!)

 More information: https://www.itb.com/en/ausstellen/exhibition-areas/medical-health

The Bled Water Forum is currently leading several international initiatives focused on:
• New frameworks for drinking water quality
• Mineralization and classification profiles
• Source protection and public water excellence
• Advanced certification systems for institutions and facilities offering high-quality drinking water
• Education and development of water sommeliers and water technologies

We strongly believe that the European spa sector – with its deep heritage, scientific knowledge, and operational expertise – represents one of the most advanced real-world applications of mineral and natural waters for health, wellbeing, prevention, and medical tourism. This makes ESPA a natural and essential partner in shaping the future of water standards.

Together, we aim to co-create:
Global quality standards for drinking and spa waters
Classification and mineralization frameworks connecting health, wellness, and public water systems
A new certification system for destinations and facilities offering exceptional drinking and mineral waters across hospitality, spa, medical, and public environments

This cooperation will connect scientific, regulatory, and operational perspectives into a coherent European and global reference framework for water excellence.

Bled Water Forum in June, with a dedicated panel or keynote on:

More information about the Bled Water Forum: https://bledwf.com/

We look forward to shaping the future of water—together.