Whenever I visit, I switch to my US SIM card and am immediately bombarded with spam texts (mostly from political parties) and scam calls. In my experience, Android is pretty good at marking calls and texts as "potential scams," but they're still there. In the Netherlands, I've gotten a few scam attempts via WhatsApp. Other than that, I think I've received one phone call soliciting donations to the Red Cross, and nothing else.
Personally, the only “spam” I get is flagged by the cellular provider and 99% of the time the calls are silenced. Not really an issue for me. The only people that “call” me are in my contacts list anyways. Everyone else can leave a VM or text message.
Luckily at the moment, there's still a delay after you answer the call as (I assume) you're being connected to a human. How long will this last....?
Currently, when I don't hear a voice within 1s or so, I hang up. A legitimate caller will (hopefully) call back pretty quick.
I had issue with Vodafone here - they were pestering me with calls/messages... even after I switched to Digi they were calling me for a week to try to convince me to stay (it just confirmed my decission to switch ;) )
They target the US, and to some extent the UK, Gulf countries like UAE where English is the de facto language.