We are deeply honoured to receive this inspiring message from Ms. Ekaterina Zaharieva, EU Commissioner, on the occasion of the 30th Anniversary Congress of the European Spas Association.

Her words highlight the vital role of Europe’s medical spas and natural health resorts in advancing preventive healthcare, sustainable tourism, and climate-responsive wellbeing.

“Reaching three decades of leadership in promoting preventive healthcare, sustainable tourism, and climate-responsive wellness is an extraordinary achievement. Your continued dedication to positioning Europe’s medical spas and natural health resorts at the forefront of innovation is both visionary and deeply aligned with the EU’s goals for longevity, resilience, and green transformation.”

This recognition reinforces our shared mission — to bridge tradition and innovation, ensuring that Europe’s healing destinations remain key contributors to longevity, resilience, and sustainable development.

We thank Commissioner Zaharieva and the European institutions for acknowledging our collective efforts. Together, we continue building a healthier and more sustainable Europe — one where nature, science, and wellbeing go hand in hand.

On 15 January 2026, the European Economic and Social Committee (EESC) hosted an Expert Hearing on Life Sciences and Rare Diseases as part of the work on TEN/867 – The European Life Science Strategy along with the Strategy on Research and Technology Infrastructures with a focus on the treatment of rare diseases.

We would like to express our sincere appreciation to Rapporteur Milena Angelova and President Martin Böhme, whose leadership and openness to a holistic perspective made it possible for the European Spas Association to contribute to this important process. Their willingness to consider the broader value of natural health resources created a unique opportunity to bring balneology and climate health into the European debate on life sciences.

The Expert Hearing brought together policymakers, scientists, and health stakeholders to discuss priorities for Europe’s evolving health strategies. The European Spas Association was honoured to participate, represented by Dr. Siyka Katsarova and Csilla Mezősi.

The discussion focused on the role of medical spas and climate health resorts within Europe’s future health policy. A clear message emerged: medical spas are not simply a matter of tradition or wellness tourism. They are evidence-based, physician-prescribed health infrastructures that play a meaningful role in prevention, rehabilitation, mental health support and improved quality of life — including for people living with chronic and rare diseases.

Recent advances in life sciences strongly reinforce this position. Research ranging from thermal water biochemistry to inflammation pathways and microbiome science confirms the solid scientific foundations of balneotherapy and climatotherapy. When combined with digital health tools and telemonitoring, these therapies are fully aligned with Europe’s health innovation ecosystem and modern models of integrated care.

Participants at the hearing highlighted the broader value of medical spas and climate health resorts as resource-efficient and low-impact health infrastructures. Closely linked to climate adaptation, they contribute to health resilience, healthy ageing and sustainable healthcare delivery — priorities that are increasingly central to European policy debates.

The exchange was marked by strong support from experts and representatives of several EU Member States, including Romania, Slovakia, Germany, Italy, Hungary and Bulgaria. These contributions underlined the clinical value, scientific credibility and sustainability impact of Europe’s natural health resources, and called for their greater recognition within EU life sciences and health strategies.

There was broad agreement that the integration of life sciences, digital health and nature-based therapies is not a distant ambition. It is already taking place across Europe’s medical spas and climate health resorts, demonstrating how traditional natural assets can be successfully embedded in contemporary health systems.

The European Spas Association warmly thanks the European Economic and Social Committee, as well as all participating experts and Member State representatives, for an open, constructive and forward-looking discussion. The shared support expressed during the hearing sends a strong signal: Europe’s natural health ecosystem is a strategic asset for public health, innovation and sustainability, and an opportunity that should be fully embraced within the European Life Sciences Strategy.

A record-breaking 27 applications were submitted across eight categories, each meticulously reviewed by a distinguished panel of six expert jury members.

And now, the moment we’ve all been waiting for — we are proud to reveal the winners of the ESPA Innovation Awards 2025.

Winner in category C1- Innovative Spa Destinations
De Montel – Terme Milano, Italy

Winner in category C2 – Innovative Medical Spa 
Medical spa Narva-Jõesuu, Estonia

Winner in category C3 – Innovative Spa Design Hotel
Gradiali Medical SPA & Wellness spa area, Lithuania 

Winner in category C4: Innovative Spa Concept
Aukštoji Liškiava, wellness and leisure residence, Lithuania 

Special jury award in category C4: Innovative Spa Concept
“Kids’ Republic” – Innovative SPA concept, Hot Springs Banya, Bulgaria

Winner in category C5: Innovative Health Spa Programme
Inspiro Medical Center, Bulgaria 

Special Jury Award in category C5: Innovative Health Spa Programme
Oncology rehabilitation programme, ENSANA, Marianske Lazne, Czech Republic

Winner in category C6: Innovative Spa Products
VR Medical, Czech Republic

Special Jury Award in category C6: Innovative Spa Products
Mineral-rich water spray, Värska Sanatoorium, Estonia 

Winner in category C7: Innovative Spa Education
SpaEdu by Wellandia, Romania 

Special Jury Award in category C7: Innovative Spa Education
Institute of Spa & Balneology, Czech Republic

Special Jury Award in category C7: Innovative Spa Education
Publication “Medicína přírodních léčivých zdrojů”, Czech Spa Association

Winner in category C8: Innovative Spa Research
The Masak system by Bescored, France 

Special Jury Award in category C8: Innovative Spa Research
Multimodal fibromyalgia rehabilitation, Fürstenhof Klinik, Germany 

Congratulations!

Stop by the ESPA stand to experience:

• Water tasting with mineral water from Slovenia, Bulgaria, Czechia, Germany, Romania, Lithuania, Georgia, and Iceland.
• Mud application from Lithuania.
• A special massage corner.
• A presentation of the medical tourism management study program by the Deggendorf Institute.

Don’t miss ESPA members at the ITB Hall 4.1 STAGE:

March 4, 2025, 14:00–15:00

• Bulgaria is Redefining Its Image as a Destination for Affordable Luxury, Focusing on Spa Treatments and Natural Beauty
  • Mr. Miroslav Borshosh, Minister of Tourism, Republic of Bulgaria
  • Dr. Siyka Katsarova, President, Bulgarian Spas and Balneology Association

March 5, 2025, 10:00–11:00

• Health Tourism Management / How to Meet the Needs of Gen Z as Travelers and Employees
  • Anke-Andrea Sponer, International Competence Center for Health Tourism, Deggendorf Institute of Technology (with students)
  • Csilla Mezösi, SG European Spas

March 5, 2025, 12:00–13:00

• Demographic Changes, New Concepts in Health Tourism, and Longevity: The Role of Promoting Health Tourism, Thermal Springs, and Climate Resorts
  • Albert Zinevic, Sales Director, Egle Medical Spa; Member of the National Association of Rehabilitation Centers and Medical Spas of Lithuania
  • Martin Plachy, CEO, Royal Spa Hotel, Czech Republic
  • Frank Halmos, CEO, Ensana Health Spa Hotels
  • Csilla Mezösi, Secretary General, European Spas Association

March 5, 2025, 14:30–15:00

• New Priorities of the New Transport Committee
  • Presented by Daniel Attard, MEP, European Parliament

March 5, 2025, 16:00–17:00

• The Healthy Water Initiative: Highlighting the Benefits of Drinking Cures and the Positive Effects of Natural Remedies
  • Iztok Altbauer, CEO, Slovenian Spas Association
  • Iuliana Tasie, Vice-President, Romanian Spa Operators
  • Hans-Jürgen Kütbach, European Affairs, German Spas Association (Deutsche Heilbäderverband)
  • Alina Huseynli, Director, Institute of Spa and Balneology, Czechia

Complete programme: https://www.itb.com/de/besuchen/eventuebersicht/

This event, organized by the National Association of Medical Spas and Rehabilitation Centers along with the Lithuanian Resorts Association, aimed to draw attention to innovations in Lithuania’s health sector and highlight the country’s natural resources and wellness potential.

According to Assoc. Prof. L. Rapolienė from the Faculty of Health Sciences at Klaipėda University, mud therapy has a positive effect not only on the skin but on the whole body. “Mud therapy stimulates circulation, reduces inflammation, and promotes healing processes. Additionally, it helps reduce stress and encourages regenerative processes,” explained the scientist.

Representatives of international organisations overarching the medical spa industry, health resorts in Europe, representatives of universities and institutions specialising in balneology research, representatives of spa towns and municipalities and other institutions involved in the medical spa industry met in Karlovy Vary as part of the European Spa and Balneology Congress to discuss the challenges faced by health tourism including the spa industry in today’s turbulent times.

In conclusion, they decided to formulate a joint declaration to make an appeal to the elected representatives of the European institutions and to the candidates for the EU Parliament elections to support the medical spa industry and European health destinations, not to underestimate the industry’s therapeutic significance and other benefits, and those who save a lot of money for public health, and not to neglect this in the strategic plans and meetings of stakeholders, and concepts being developed at the level of European institutions.

In line with the subtitle of the congress: “European Spas, a Path to a Healthy Life”, the attendees state the following:

European medical spa industry – world cultural heritage and tourism phenomenon

I. The European territory abounds in a wealth of natural medicinal resources, the effects of which started to be used centuries ago to treat and prevent illness. It was often the strong personality of a reformer, a healer, who promoted new treatment methods using natural resources. The varied history of spas and the spa industry is thus not only part of the history of medicine but is also associated with the development of culture, natural sciences and technology.

The systematic development and promotion of spa towns has resulted in the addition of 11 leading European spa towns on the UNESCO World Heritage List in 2021. In addition to the exceptional architecture of the spa towns, this recognition is mainly due to the phenomenon of spa stays, including treatments and balneological procedures that improve the health of spa guests. Their addition on the World Heritage List confirms the spas’ uniqueness, representing a huge potential for tourism, rural development and a great commitment. The signatories to the Declaration therefore wish to highlight this exceptional heritage which must be protected and preserved for future generations.

European medical spa industry – a vital component of the health care of European citizens

II. Balneology, as a scientific discipline focusing on spa treatment, is perhaps one of the oldest therapeutic methods for human civilisation. Balneotherapy is a curative and preventive medical discipline. Traditional medical spas offer a return to nature and its rich resources instead of chemical treatments. Spa treatment has a proven beneficial effect in the treatment of many diseases. Moreover, the positive effects persist for several months after the treatment ends. Prevention plays an essential role in the spa industry and our members welcome a growing number of self-payers. That is one of the reasons why people return to the spa regularly. The importance of prevention, and boosting the immune system has been demonstrated by the recent COVID-19 pandemic.

The congress attendees would therefore like to draw the attention of European policymakers to the enormous healing potential of medical spas. Europe’s health resorts should get a much more visible integration of EU policy in EU4H and regional sustainable development strategy. Let us start by using these services to treat all the post-COVID consequences that affect more than 1% of the European population.

European medical spas – a place to take care of our ageing population.

III. Today, Europeans live longer and healthier lives than most people worldwide. However, Europe’s population is ageing, and a radical change in demographic trends can be expected in the next two decades with around 30 per cent of the European population over 65 years of age. This will increase the need for more efficient healthcare and social systems. We have to look for potential solutions, such as health resorts with the medical competence to improve the health and social care of Europe’s ageing population – also in rural regions!

Efforts to maintain or improve the health of body and mind/longevity programmes currently present a vast potential for innovation, and spa towns are precisely where services can be offered to ill clients and those who want to work on their health to prolong healthy life years.
The Karlovy Vary Spa and Balneology Congress attendees believe that medical spas will continue and will play an even more important role in the care of the ageing population in the years to come. Spa experts are encouraging policymakers to recognise this strength of the spa industry and to help put it to use as best they can.

European medical spas – a time-honoured sustainable development concept for Europe’s economically weak regions

IV. As a specific tourism sector, the spa industry plays a major economic role in its respective regions. Most importantly, it is a major employer. As a labour-intensive industry, it offers employment directly or in related sectors to almost a million people in around 1,400 spa locations across Europe, where spa guests spend nearly 200 million nights. In addition to the cultural and social significance of spas, we must not forget environmental protection. It is one of the essential factors and one of the main attractions of health resorts. In spa towns and climate health resorts (mountain, seaside), there are strict environmental regulatory restrictions in place concerning the management and maintenance of medicinal springs, waste management, noise restrictions, traffic restrictions, energy management and, last but not least, urban greenery care and maintenance. Attention is also being paid to improving the environmental management of spa complexes and businesses and the management and coordination of spa locations and the regions in which they are located. Negative environmental impacts are continuously monitored and analysed, leading to increased investment in modern technologies to monitor the environmental state of a given location. The signatories to the declaration are convinced that this is where spa locations can serve as an example for other regions. Environmental protection is a global issue today in which the role of spas should certainly not be neglected.

The purpose of the declaration is to draw the attention of European policymakers to the enormous potential that medical spas and climate health resorts offer. Support them and use them not only as part of public healthcare programmes. Their cultural and historical heritage also deserves protection, including taking care of the areas rich in natural medicinal resources that are used for spa treatment and make them unique.

We must all work to ensure this unique natural wealth remains preserved for future generations and integrated into the health care system.

Thank you for your support!

The undersigned statutory representatives of the listed institutions:

European Spa Association
Czech Healing Spa Association
Hungarian Spas Association
Bulgarian Union of Balneology and Spa Tourism
Croatian Chamber of Economy
German Spas, Deutscher Heilbäderverband
La Medicine Thermale, le Conseil National des Etablissements Thermaux (C.N.E.Th)
Icelandic Spa Association
Federterme, Italy
Lithuanian Kurortu Association
ENSANA Health Spa Hotels
Vita-Con Consultancy BV
The Organization of Spa Owners in Romania
Wellness Klaster Serbia
Slovak Spa Association
Slovenian Spas Association
The National Association of Spas (ANBAL)
International Society of Medical Hydrology and Climatology
AFRETH,l‘opérateur national de la Recherche thermale
Sairme Health Resort, Georgia
Fra Mare Thalasso, Estonia
Mondorf Domaine Thermal,Luxembourg
Aqua Treatment real estate development
World Federation of Hydrotherapy and Climatotherapy
European Health Management Association
European Historical Thermal Towns Association
Deggendorf Institute of Technology
ITB Medical Tourism
Institute of Spas and Balneology Karlovy Vary
Regional Office of Karlovy Vary
City of Karlovy Vary
Great Spas of Europe
Leaders of Tomorrow Institute
CzechTourism
Slovenian Tourism Board
Sri Sri Tattva Europe
Mirabilia Network

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BALNEOTHERAPY HAS A PARTICULAR ROLE TO PLAY FOR PATIENTS WHO HAVE FAILED TO RECEIVE TREATMENT.

Claude-Eugène Bouvier is the creator and founder of an online library, which collects all scientific studies of balneology/spa medicine in one place at the European Spas website and makes them available free of charge. 

What health problems and outcomes are most important in today’s society?

The health expenditures of European countries have been undergoing a paradigm shift since the beginning of this new century. Previously burdened by the cost of treating contagious diseases (tuberculosis, influenza, measles, STDs, etc.), health budgets are now strained by the cost of treating non-communicable diseases, many of which are so-called civilizational diseases, related to diet, lack of physical activity, addiction (alcohol, tobacco, drugs) and the effects of a potentially harmful environment. Many of these diseases are chronic: they are long-lasting, progressive, and can be controlled but rarely cured. In most Western countries, these chronic diseases now account for 80% of the annual increase in healthcare spending. 

What is the potential of natural resources such as natural healing water, peloids, gases, and climatic conditions for treatments? How do you see future development?

In the context of these chronic diseases, balneotherapy has a particular role to play for patients who have failed to receive treatment, have no therapeutic alternative, or simply need a treatment that complements the one offered to them through their general practitioners. When we look at the complaints of chronically ill patients, those most frequently expressed are pain, limitation of abilities, i.e. discomfort or handicap in the execution of daily life gestures (climbing stairs, tying shoes, grooming, etc.), and reduction in quality of life. These are precisely the areas in which the spa treatment provides benefits.

THE EUROPEAN MEDICAL SPAS WERE THE FIRST TO TREAT POST AND LONG COVID PATIENTS.

France is a case example of how scientific studies and market information can be used in disputes with health decision-makers. They regularly conduct and sponsor studies in cooperation with the members. Where is balneology most recognized and successful?

In France, as in all other countries, public health budgets are under great pressure. Hence the need for public decision-makers to finance only those services and procedures that are useful to the community. This context has encouraged the emergence of evidence-based medicine. Since 2003, the balneotherapy sector has been contractually obliged to finance studies evaluating the medical service rendered by spa treatments. That is an essential condition for maintaining the 65% reimbursement rate by Health Insurance. The thermal operators have financed more than 15 million euros worth of studies with positive results, mainly in the field of rheumatology, fibromyalgia, chronic venous insufficiency, psychosomatic affections and dermatology.

Which studies are read the most in the ESPA e-library and why?

The ESPA e-library is unique as it is an exclusive collection of studies on balneotherapy, regularly updated and freely accessible to the general public, physicians, policymakers and researchers. It contains more than 1,300 references. In most European countries, rheumatology (osteoarthritis, arthritis, low back pain, etc.) is the predominant indication. It is, therefore, quite normal that this is the subject most investigated by researchers and also the most read. But current events can change the interests of e-library users. In 2022, the researches related to the contribution of balneotherapy to the management of the long-Covid were the most frequent.

THERMAL SPAS ARE PARTIUCLARLY WELL SUITED TO THE IMPLEMENTATION OF PREVENTION.

What are the newest and hottest topics in thermal medicine?

The health crisis linked to Covid has underlined the legitimate role of thermal medicine in the management of pathologies linked to long Covid. It has also opened the debate on the interest of the thermal cure on the reinforcement of immunity. There are many a-priori and ready-made ideas on the subject and some sort of empirical evidence, but we lack a robust study on the subject. The European medical spas were the first to treat post and long covid patients, starting in 2020. We are proud to say that we have one of the greatest know-how in this area. According to our study from 2022, 16 European countries with natural remedies offer Long covid treatment. 

Among the other hot topics, I notice a strong interest in the microbiome, a fashionable topic that has invited itself into thermal research. There is a current interest to study the modifications induced by thermal treatment on the microbiome, whether it is intestinal or urinary, or even the microbiome of the skin.

How do you see the importance of health prevention? Is the percentage of prevention programs growing compared to rehabilitation programs? Can we expect that national health insurance will cover health prevention programmes in the following decade?

Thermal spas are, unlike other types of health facilities, particularly well suited to the implementation of prevention. The patient is available for a long period of time and is pro-active. The cohorts of patients are homogeneous, facilitating the messages and the prevention programs, especially since the medical and paramedical skills are already in place. There are three fields where thermal medicine is particularly relevant; these are:

– the prevention of overweight and obesity (According to a WHO report dated May 2022, Europe is facing an “epidemic” of overweight and obesity that affects nearly 60% of adults and nearly one child in three),

– the prevention of cancers and their relapses (NB: in France, the health insurance funds a program of thermal treatment for women in remission from breast cancer),

– prevention of loss of autonomy: healthy ageing is a major issue, and spas that welcome many seniors are well placed to participate. For example, at the end of 2023, French Health Insurance will finance a program for the detection of frailty in spas based on the ICOPE program promoted by the WHO.

What is your personal and professional goal for better recognition of balneology? Where should it be positioned in 10 years?

Thermal medicine is still perceived as a second-class medicine in the “blind spot” of health policies. Its resources are not sufficiently harnessed and often the spa treatment is not part of a patient’s care plan. I am convinced that this is going to change because thermal medicine has many assets: it is natural, without iatrogenic side effects and efficient for some chronic pathologies. It must stop being a “catch-all” medicine and better identify the fields in which it is really adapted. That calls for a better evaluation of the efficiency of the classic thermal cures, but also of the new prevention programs. It also requires a more solid place of balneology in the medical teaching, and also better training and information of the prescribing doctors.

Read more about the e-library at: https://europeanspas.eu/e-library.

The topic of energy is fundamental to all our economies and considered as the basis of value creation

With the challenges brought along by climate change and the ever-growing energy demand, the need for sustainable solutions has never been more pressing. The vision of W&P Engineering is to be an impactful company and lay the groundwork for a world powered entirely by green energy. Their core drivers are innovation, eco-friendly technologies and smart solutions that can answer today’s questions and solve tomorrow’s problems. W&P Engineering provides tailor-made solutions for each individual hotel with the latest sustainable technologies.

Joel Vogl joined the W&P Engineering Group a few years ago and took over the management of the international division and serve on the Board of Directors. Through his influence, an own Spin-Off focusing on Hydrogen-based solutions with the name INFENER was founded.

In more than a decade many things have changed in terms of climate change and our understanding of sustainability. What would you say about the improvement in your field? Is the demand for sustainable solutions growing fast enough?

Years ago, I started my career at a global market leader in its sector, which is known for very energy-intensive production processes. The topic of sustainability and energy transformation for the benefit of the climate was on the daily agenda. The pressing issues have been known for decades and the massive consequences for the global climate have been scientifically proven. Short-term thinking, quarter-to-quarter, and frequently changing management in large companies and bonus systems that usually only take economic parameters into account, have mostly cut back on meaningful investments in favour of a more sustainable future. Forward-looking managers lead their companies today to the difficulties of the future and make them competitive in order to be resilient and able to survive in the market tomorrow. The topic of energy is fundamental to all our economies and is considered as the basis of value creation. At W&P Engineering and INFENER, I now have a different perspective as we provide the solutions that are needed all over the world. We work with companies from many different sectors that have a great need for optimisation in highly complex systems or want fundamentally new concepts for new construction projects. There are many enormously exciting future technologies. But some technologies have been known for years and could have made a difference early on. We mostly work with innovative-thinking clients who understand that sustainable investments are the way to go. But there are also quite a few potential clients who have not understood and are today enormously overburdened with energy prices. Here we have to say that it is not too late to act, but waiting and doing nothing will destroy the business in the short or long run.

Your company is specialized in energy efficiency and the integration of renewable energy solutions in different types of buildings. How long is the process from planning to execution?

Depending on the size and complexity of the project, one can expect between several weeks to months to even years. This really depends enormously on what kind of project it is and whether external resources are sufficiently available for implementation. We have developed a very lean and fast process, especially for energetic redevelopment, and can evaluate and simulate the optimal location-based solution. There is never just one solution, especially in existing buildings. It is very important to examine the different variants in detail and to include an economic efficiency study. With new buildings, of course, we have the possibility to plan everything from the very beginning. This offers incredible opportunities for state-of-the-art innovations. Above all, energy and building technology can be ideally harmonised in a new construction. This results in completely new standards in terms of building design. For example, it makes a lot of sense to activate the façade of a building and use it as an energy generation area. In some cases, new buildings can even be designed to be energy-positive, i.e. they generate potentially usable income.

the balancing act between modernisation and technical renewal must be ensured

Among your projects, we can see Spa Hotels and Resorts as well. What are the specifics when we are talking about Thermal Spa Resorts? 

Spa hotels very often have similar characteristics. Basically, the loads are quite high, as there are continuously many consumers at good occupancy, e.g. there are often many saunas, washing machines, and dryers with daily running times and high peak loads. With peak shaving, a lot can be achieved here. Since Thermal Spa Hotels use a lot of water to provide a pleasant and luxurious experience for their guests, this requires special energy efficiency. Natural thermal water can have a huge variance in terms of output temperature. It often needs to be further heated for the treatments and pools. But there are also cases where the water needs to be cooled down because it’s too hot. There are many pumps running at high power. A lot of waste heat is generated that can often be used. From a geological point of view, it is not uncommon for thermal spa hotels to have the opportunity to think further about the geothermal processes and thus smooth out the heat demand in the winter season or even use it irreversibly for the air conditioning of the building. Very outdated system and control technology is often found in thermal spa hotels. Many of these hotels originated historically and were developed and built in a pioneering effort. Historic buildings must of course retain their charm and yet be technically renewed, otherwise they become uneconomical. Here, the balancing act between modernisation and technical renewal must be ensured. That is the special challenge.

Your view and solutions are holistic. It is not enough to change only the source of energy, but to include other areas as well, like mobility, waste management and water management.

Absolutely! A holistic view in engineering that covers all relevant mass flows is very important to close loops and exploit the full potential at a site. I am a great friend of a very high level of operational safety for the business, a high degree of self-sufficiency and well-considered sustainability resulting in the base for increased local value creation. In a globally complex world, we must manage to think about our needs and consumption more locally again and reduce dependencies. Especially in the energy sector, we all feel how important decentralisation is. Water scarcity is becoming increasingly severe worldwide, waste production continues to rise and at the same time, we are experiencing a transformation of mobility. When it comes to water, we focus on the careful use of this valuable resource while maintaining comfort. We close water cycles and can thus minimise consumption. Waste can become a valuable resource in terms of energy, for example, if we take a closer look at the different types of waste. Of course, we always have to evaluate the set-up and the quantity balances, but basically, we have to take a step towards even more circular economy.

In the mobility sector, we are increasingly seeing hybrid vehicles, electric vehicles, hydrogen vehicles, the methanol fuel cell and much more that is still to come. Particularly in the case of electromobility, we are happy to look at how this can be integrated at a suitable project location.

There is no good off-the-shelf sustainability solution

What would be your advice to the Thermal Spa Resorts that are thinking about implementing a sustainable concept? Where to start? 

Always start with a potential analysis or rather a variant study. I always have to emphasise this. There is no good off-the-shelf solution. Every location has its special features and must be assessed individually. The best concepts result from good data and a well-thought-out comparison of variants. I always recommend investing in something at the beginning in order to move in the right direction. Often there is a local network of companies that have only been doing what they can do for years, always have the same suppliers and hardly dare to innovate. That is different with us. We look at every project with an open mind and evaluate it in a product-neutral way. We are at the forefront of innovation and proactively help shape it. Any investment in a technical feasibility study pays off. Start with it!

Can you explain to us your approach to one of the Spa resorts: Balvanyos Resort in Romania, which is also a member of ESPA and winner of the award for innovation and excellence in the European SPA & Health Resorts Industry?

2021, we analysed the Balvanyos Resort in Romania in detail and developed four different variants of energy transformations for the existing hotel and the new extension. Moreover, the entire building technology and also the technical system of the spa area were inspected in-depth. We were able to present variants with an annual cost-saving potential of up to 60% and a very economical return on investment. Besides the drastic decarbonization, a real added value for marketing and green tourism can be achieved.

Balvanyos is an exceptionally beautifully located and excellently managed Resort in the middle of the Carpathians. The owners do their utmost to ensure that the guest has a first-class experience. From the spa to the gastronomy and the many exciting leisure options, there is nothing lacking there. A magical place.

Which are the projects (related to tourism and especially Spa and Health Resorts) that you are currently working on? 

We are currently working on a number of hotel projects that are intended to set completely new standards in terms of sustainability. We will soon start developing a 6-star luxury resort in French Polynesia. Here there are very special challenges and incredible opportunities to develop this extraordinary resort in a natural way and without destroying flora and fauna. In addition to exceptional architecture, the main focus is on energy, water and waste. Especially islands and other remote locations are very vulnerable. Here it is worth exploiting the full potential and setting a real «lighthouse» as the standard for new developments. We are also currently working on several already existing Thermal Spa Hotels all across Europe. We are aware that this traditional Thermal Spa sector in particular has a great need for energy-efficient upgrades. We would like to contribute to making the use of these incredibly valuable treasures of the thermal springs more sustainable and economical.

My heart beats above all for innovations that lead to our economy becoming more resilient

What is your personal and professional goal in terms of sustainability?

My heart beats above all for innovations that lead to our economy becoming more resilient from the bottom up, against all crises. I would like to see more science and foresight in all topics related to sustainability. Above all, I wish for processes to be thought of in an even more circular way and for out-of-the-box ways of thinking that embrace the collective and do not just occur singularly. We are in an enormous phase of upheaval. The knowledge is there to transform the world as it is today and to save the world’s climate with enormous effort. I have great hopes for the wider application of hydrogen in our energy systems. I am optimistic and hopeful that governments in particular will show more sense in the future and break away from old structures that have always slowed down change. I would like W&P Engineering and our Spin-Off INFENER to be able to exert a convincing influence and actively shape the future.

Balneotherapy is an integral part of the Lithuanian health system

We recently talked to Nijolė Dirgičienė, the mayor of the Birštonas municipality in Lithuania. She is also the president of the Lithuanian Resort Towns Association, a member of the Local Authorities in Lithuania, ALAL Board Member and a member of the Council of Europe Congress, as well as one of the most active political figures of Lithuania.

Q: You have been involved in the Lithuanian Resorts Association since 2007. What were the most important milestones for the Association in these years?

Over the years, great efforts had to be made to achieve the recognition of the uniqueness of the Lithuanian resort towns. The Association of Lithuanian Resorts is the core, while all our resort towns are different and have their own face. Although our country’s resort towns are an integral part of Lithuania’s image and tourism, the specificity and uniqueness of these areas are still not sufficiently taken into account. Over the past 16 years, we have been able to join forces to gain recognition for the common issues of resort towns. Together, we all prepared the “Draft Law on the Sustainable Development of Lithuanian Resort Towns”, which establishes a general line on how resorts should develop in harmony with the environment, social changes, while using our infrastructure and natural resources efficiently. We are already waiting for the consideration of the draft law in the Parliament of Lithuania and we are sure that its adoption will benefit not only resort towns, but also for Lithuania as a state in general and the country’s residents themselves.
We are also particularly proud that today the benefits of natural resources and the need for scientific research are no longer in doubt. There is political will and common understanding, but we all have to find tools together to implement research and lead the Lithuanian balneology sector to new heights.

Recently, we received the recognition of German statutory health insurance funds for the reimbursement of outpatient health services in Lithuanian spas. This is an extremely big step for our country, towards which we have been working for many years. However, we understand that this is only a motivational tool, and the biggest work is still in the future.
The problems faced by resort towns and resort areas are recognized, and in many cases solutions are sought. We are making great efforts so that resorts and resort areas have even more opportunities to develop, renew, increase attractiveness and at the same time contribute to economic growth of the country.

Q: How important are the economic impacts of medical and spa tourism in Lithuania and what are the other multiplicative effects for your country?

Balneotherapy and medical & spa tourism is an integral part of our health system and economy, contributing significantly to the strengthening of Lithuania’s competitiveness and GDP growth.
Currently, the tourism sector in Lithuania generates about 4% of GDP. We are ready grow and to contribute even more significantly to the country’s economic growth. The positive impact is felt not only by the resort towns themselves, our sanatoriums, medical spas, but also by elastically related economic sectors – institutions and businesses working in the sphere of accommodation, catering, service organization. Our resort towns and medical spas are the special gems of the country – they generate the largest tourist flows after the big cities. Let’s say, a third of Germans and Latvians and even 66 percent of nights spent by Israel tourists was given specifically in our resort towns in 2022. The potential is considerable, but we can and are capable of offering and providing resort recreation and balneotherapy even more widely.

Q: How do you see the further development of your association and where do you see its potential in the future?

At the moment, the full potential of Lithuanian tourism sector is not being used, it is about 4%. GDP. Resort towns in general are ready to provide even greater benefits to the country’s economy than before – of course, this requires the help of the state itself.
Lithuanian resort towns are ready to compete with other European countries with their quality of balneotherapy treatments and tourism services. Therefore, we will continue to work together to increase the flow of incoming tourism and investments in the resort towns themselves.

Q: In your role as a Mayor of Birštonas, one of the renowned spa towns in Lithuania, what are your goals and priorities to further develop and promote medical and spa tourism?

Historically and culturally, Birštonas is one of the oldest resort towns in our country. We have a beautiful history and we are very proud of it. We always highlight balneology as the most important value of our city and we will never lose it. Our goal is to make balneology even more attractive and accessible, to educate visitors, to give them a real touch of natural resources, to awaken people’s awareness in a contact with nature, mineral water. We want every visiting tourist, whether it is a mother with a baby or an elderly couple, to feel the power of nature, to inspire, to make them rethink their values (habits, diet, etc.). We develop the city in such a way that natural resources can be tested in the fresh air – after simply taking off your running shoes, wade through the mineral water and perform the “Kneipp coffee” ritual, breathe in the steam of the mineral water at your leisure with a book in hand and try forest bathing. We believe in this philosophy and develop the resort town based on these values. We believe this is our strength. We are constantly developing the infrastructure of the resort: expanding the network of bicycle paths, reconstructing parks and squares. In the near future, the construction of a pedestrian and bicycle bridge over the Nemunas river is planned. Spa complexes are being developed in the Birštonas resort town, more and more quality catering and leisure services are being established. We are also proud of our exceptional natural values – we are a green resort town, developing in this path.

With time and the right evidence, Balneology can replace pharmaceuticals and help people

Q: What are the main challenges of medical, spa & wellness tourism in Europe?

We are facing too little attention to balneology and spa & wellness tourism and its development, lack of financial instruments for the resort towns’ development and balneology research. These elements are extremely important, some countries implement them more widely and consistently, while other countries are still looking for ways of solutions and financial opportunities.
The current post-pandemic situation has clearly shown how important immunity is. To strengthen it in European spas, we use centuries-old healing traditions, the natural wealth of the depths of the earth – mineral waters, mud – and apply it to innovative uses. High pace of life, stress leaves a clear mark in today’s society, especially among young people. Balneology can serve well in this context – we are sure that with time and the right evidence it can replace pharmaceuticals and help people.

Q: Sustainable tourism and regenerative approach are hot topics nowadays. How successful is health and spa tourism in this field and what can be done to reduce the negative impact on the environment?

This is fundamental part to the development of today’s resort towns. Nature protection is becoming an increasingly important part of our lives, and there is no doubt that we must make as much effort as possible to make tourism sustainable, protecting the environment and nature. Both the resort towns themselves and the businesses operating in them have been taking all measures for quite a long time to reduce the footprint of their activities on the environment. We are moving to ecological development solutions, we are promoting green energy and transport. We see that people themselves are much more aware, but we must not forget to constantly educate them and offer them sustainable alternatives at every step they take.

Q: How do you see the role and importance of the European Spas Association? Which should be its main activities to help its members?

Each partnership in the association or organization is important to the extent of how much of your expertise, attention, and contribution you put into its activities yourself. ESPA has been an irreplaceable partner for the Association of Lithuanian Resorts for many years, we participate in all the activities, actively cooperate in the ESPA contact network. We see meaning and result in this cooperation. More and more of our members and their partners discover ESPA events, e-library, we notice a desire to be involved in its activities and grow.

Q: Which are the innovations in your members’ spas that you are most proud of?

The medical spas operating in Lithuania resort towns are creating unique health and wellness programs after Covid, which help not only to strengthen immune system, but also to restore the body. We hear from many partners and clients that our medical spas do not resemble the environment of regular health care institutions: they are like “boutique” hotels where you can find the most innovative and personalized service.
Of course, our medical spas are full of the latest high-end equipment: cold chambers, hyperbaric oxygen therapy, sleep capsules, the most innovative devices for examining body data. Medical spas pay a lot of attention and invest into this.

Q: Which are the treatments in the Lithuanian spas that one should not miss when visiting Lithuanian spas for the first time?

Our uniqueness is mud and mineral water procedures. We could single them out as part of our culture and traditions as well. Although trends change, new tools and equipment appear, but mud and mineral therapy is always what sticks in the memory of visitors the most. The Amber spa therapy, performed in one of the medical spas in Birštonas is a set of unique procedures that help to use the energy of amber accumulated over millions of years to improve human health. Flow therapy, which has no analogues in the Baltic countries, is also worth trying – it uses mineral water containing 70 active mineral elements: in just 20 minutes in a state of weightlessness, the body absorbs as many trace elements as it would not receive in any other form!

Lithuanian medical spas perform many unique procedures, so everyone will find one that suits them, all you have to do is listen to your body’s needs.

Meet us at the Medical Pavilion Stage (HALL 26c) and at the European Spas booth 301A.

From 7 to 9 March 2023 at the Medical Pavilion Stage/Education Hub at ITB Berlin, the European Spas Association together with its key partners and members, will be holding some very interesting discussions. Medical and health tourism plays an important role at ITB Berlin 2023.

Key industry players will be talking about optimisation of spa hotel operations, marketing in health resorts, sustainable investments, nutrition, mental health, and much more. 3 days of business, new connections, exchange and education await.

Programme at the Medical Pavilion Stage HALL 26c

7th March 2023

11.30 – 12.30 h PANEL DISCUSSION: Optimization of spa hotel operations with:

• Martin Plachy, CEO Royal Spa, Czech Republic www.royalspa.cz
• Petra Lelovska, Vice President Ensana Health Spa Hotel Group, www. ensanahotels.com
• Dr.Siyka Katsarova, President BUBSPA, www.bubspa.org/en
• Edgaras Briedys, B2B Sales Director Eglės sanatorija Lithuania, www.medicalspa.lt

16.30 – 17.00 h EXPERT INTERVIEW: Implementation of successful communication of health resorts: green-active-healthy

• Iztok Altbauer, Managing Director, Slovenian Spas Association, www.slovenia-spa.si

17.00 – 17.30 h EXPERT INTERVIEW: Healing power of the sea – Thalasso

• Marlies Sobczak, CEO Vita-Con Consultancy, Netherlands, www.europeanspas.eu/thalasso-working-group/

8th March 2023

14.30 – 15.30 h PANEL DISCUSSION: New Products in health tourism – combining nature and sustainable investments with:

• Iuliana Tasie, General Manager, Ana Hotels Eforie Nord, Romania, anahotels.ro
• Ivana Kolar, CEO of Julius Rose Business consulting, www.turizam365.com
• Dr. Michael Feld, Specialist for sleep disorders, Germany

15.30 – 16.00 h Nutrition – from ordinary to extraordinary / Overfed, but undersupplied
How to improve your clients´ diet?

• Alexandra Friedhoff, Nutrition and Health Coach (LCHF), Germany, https://www.alexandrafriedhoff.de

16.00 – 16.30 h EXPERT INTERVIEW – Evolution and Expansion of Ensana Hotels

• Frank Halmos, CEO Ensana Health Spa Hotel Group, www.ensanahotels.com

9th March 2023

10.30 – 11.00 h EXPERT INTERVIEW- Growing demand for mental health, Thierry Dubois President European Spas Association and representing Thermes Saujon, France, www.thermes-saujon.fr

11:00-11:30 EXPERT INTERVIEW- The chances of high security of supply and independence from market fluctuations through renewable energies, Christoph Waser, CEO, W&P Engineering, www.wpeng.de

13:00-13:30 PANEL DISCUSSION about Prevention and Wellbeing – key focus areas and strategies for Growths Csilla Mezősi, Secretary General of European Spas Association

16.25–17.10 WOMEN AND MEDICAL TOURISM by European HTI Summit, hticonference.com

CONVENTION Hall 3.1

In the evening of 9th March, starting at 7 p.m., the ITB Medical & Health Night will take place at the Amaro Hotel Grand Central, featuring the presentation of the ITB Medical & Health Tourism Award 2023 in partnership with European Spas Association.

See you at ITB 2023!

HALL 26c booth 301A

The European Spas Association (ESPA) is a non-profit organization that brings together 20 European countries that are involved in balneotherapy. ESPA’s main goal has been to promote the use of spa medicine in Europe as a curative and preventive approach using natural remedies, rehabilitation techniques, and lifestyle education to maintain and enhance the health of patients and guests, promote healthy aging, and improve the overall quality of life.

In the next decade, ESPA plans to strengthen its presence in Europe as an essential player in the healthcare industry for managing chronic diseases, some of which have been exacerbated by the consequences of COVID-19, such as respiratory, cardiac, neurological, psychological, and musculoskeletal disorders. ESPA will continue to develop spa wellness and prevention, areas in which spa therapy has been shown to be effective.

As natural treatments become more popular among both healthcare providers and patients, it is important to continue educating and promoting the benefits of spa medicine and prevention using natural remedies. In recent years, people have realized that traditional drug treatments are not always the best solution due to their potential side effects. This has led to a growing interest in natural treatments, and the spa industry and health tourism have been growing at an annual rate of more than 10% worldwide.

The trend in “the new normal” is very promising, but government support is a tough discussion every year due to the economic situation.

“The aim is to convey information that spa medicine and prevention using natural remedies are good investments in the health of our citizens.“

Q: The European Spas Association represents 20 countries. What benefits does ESPA bring to its members?

We provide benefits for our members through the exchange of experiences among different stakeholders, the sharing and development of best practices, and the conduct of medical and economic studies. This allows for the strengthening of spa therapy at the European level. Additionally, ESPA aims to:

• Influence policy in the European Union.
• Promote and improve quality standards in all spas and health resorts within Europe.
• Create positive perceptions about the medical benefits of spa treatments among public authorities, health funds, and medical doctors.

The ESPA Annual Congress is considered a crucial aspect of ESPA’s activities. It serves as a platform for the transfer of knowledge and best practices, and also offers recognition for the most innovative spa products through the ESPA Innovation Awards. Additionally, the congress provides new business opportunities for members. The congress is held annually in a spa town in a member country, and features a diverse range of themes, including medical, economic, marketing, and energy saving, among others. The event features a variety of specialized speakers and the Innovation Awards recognize the most outstanding achievements in Europe and provide motivation for members. Additionally, ESPA has also been organizing B2B events with spa centers and travel agencies for several years, to promote balneotherapy in these cities.

“The ESPA Congress is the main annual highlight for members and professionals”

Q: How important do you consider the annual ESPA Congress to be in terms of transferring knowledge and best practices, as well as providing recognition for innovative spa products through the ESPA Innovation Awards and creating new business opportunities?

The ESPA Annual Congress, which always takes place in a spa town in a member country, is the main annual highlight for members or professionals attending the congress.

The themes are very varied (medical, economic, marketing, energy saving, etc.). Numerous speakers specialised in their field develop current or prospective themes.

The Innovation Award recognizes, in several categories, the most outstanding achievements in Europe and provides a stimulus for members.

For several years, a B to B is realized with professionals of spa centers and travel agencies to favor the promotion of balneotherapy in these cities.

Q: Balneotherapy plays an integral role in preserving good health. How has the perception of balneology changed due to the Covid-19 epidemic?

The Covid-19 pandemic has completely changed the mentality of citizens. The isolation imposed by governments for many months, the teleworking, and the confined life for families in cramped housing, made citizens aware that they had to live differently.  People are moving from big cities to smaller towns, to the countryside, to the seaside, to leave a cramped flat for a house with a garden. Teleworking also encourages this relocation.

Spa therapy, and medical treatment, allows relaxation, and letting go, and many citizens come to our centers, for those who have one near them, regularly to take care of their body, of their minds. For others, they come back to the spa centres once or twice a year. Besides, numerous spa centers have developed programmes adapted to answer the needs of their patients.

“In the coming years, we will welcome more and more patients suffering from mental health problems”

Q: Discussion around mental health is gaining prominence around the world. What is your professional view on the importance of mental health and well-being?

Mental health and well-being are becoming very important issues for our citizens. This is due to the hectic life that is imposed on them because of the speed of new communication tools.

Professional burnout is increasing enormously, and disorders such as fatigue, insomnia, and even anxiety and depression are on the rise. All this has been aggravated by the consequences of Covid-19.

Our citizens are going to take more care of their health, and balneotherapy can answer their new needs by preventing and stays of well-being, in order to offer them a better quality of life in an adapted natural and sustainable environment, free of pollution.

Spa therapy has developed new programs for the treatment of these new pathologies with a strong development. It is certain that in the coming years, we will welcome more and more patients suffering from these pathologies, it is thus necessary to adapt our treatments to these psychosomatic disorders.

Q: What challenges lie ahead for spa and health tourism in the coming year?

The challenge for ESPA and health tourism is to adapt to these new pathologies, and to make this known by promoting them in our own countries, but especially at the European level.

Spa therapy is an effective healthcare tool for a large number of pathologies, without side effects and inexpensive compared to some other treatments.

Let’s promote it and continue its development.

Our organization in France has started a very important study on the ECONOMIC IMPACT of health resorts. In this study we integrate all providers of the spa industry, and this could be a prime example of a comprehensive and realistic measurement of the economic contribution to health tourism in Europe. We would like to prove this essential information about the economic effects of spa destinations and diverse important influences on employment and infrastructure of health resorts in rural areas of Europe with strong facts.

“As you see, the world is changing. Our fellow citizens have adopted a totally different lifestyle, and balneotherapy and health tourism can answer their new needs. This augurs a strong growth recovery.”

We recently spoke to Marlies Sobczak, project manager of ESPA’s Thalasso working group, who played a pivotal role in bringing the congress to Norderney. Marlies provided valuable insight into the event and the activities of the Thalasso group.

What is the main focus of the activities of the Thalasso group within the European Spas Association?

“The Thalasso working group’s focus is on the future of Thalasso and professionalization and innovation within the health and lifestyle sector. The group has the objective to make an important step in bringing Thalasso closer to people in intensive cooperation within European countries. A new cooperation between the European Spas Association and the German Spas Association has emerged, the subject of Thalasso is vital for the seaside resorts, therefore Thalasso became the leading theme for lifestyle and health on the island of Norderney. In addition to the clinics, which offer extensive programs, there are many indoor and outdoor Thalasso facilities in the region. It was obvious that this congress took place on Norderney.”

Marlies Sobczak took an active part in several forum discussions at the annual congress. She also gave a presentation on the developments and best practices in the Netherlands with a focus on Noordwijk.

Private Lecturer Dipl.-Ing. dr rer physiol. Friedhart Raschke spoke about the scientifically based and convincing effect of Thalasso on human health. The President of the DHV, Brigitte Goertz-Meißner, emphasized the importance of cooperation and the further definition and safeguarding of the Thalasso criteria. In cooperation with Wilhelm Loth, Managing Director of Staatsbad Norderney GmbH, a staunch Thalasso fan, and ESPA’s Marlies Sobczak, it was agreed to develop the Thalasso health services on a European level.

Where do you see the main challenges and opportunities?

“More and more attention is being directed towards a healthy lifestyle, also in relation to our surrounding nature, climate and focus on sustainability. This includes seeking medical supervision and the use of services of professionals. At the coast, considering the benefits of a seaside location and a healthy maritime climate, the conditions are optimal to respond to a market where there is not only demand but where the need for prevention and awareness is concretely visible.”

What is the future of Thalasso from your point of view?

“It is almost an assignment for DHV and ESPA to further develop these opportunities and translate them into a future-oriented offer. Our slogan explains it all: Power by the sea. New spirit for thalassotherapy – the use of seawater and marine environment.”

Marlies Sobczak also explains that during the annual congress of DHV in Norderney, the future program of the ESPA working group was presented. The aim is to meet once a year as a working group on a European level.

In addition, an extensive document containing several (scientifically) substantiated reports in which the effects of Thalassotherapy are described and the latest insights are expressed has been compiled. The documents and publications were obtained through various channels from Romania, Germany, and France, – Marlies Sobczak concludes.