Fiji Declares National HIV Emergency Amid Surge in Infections

Fiji has declared a national emergency regarding HIV following an alarming increase in infections, which health officials say cannot be managed through standard outbreak measures anymore.

During the announcement, Health Minister Dr. Atonio Lalabalavu indicated that over 2,000 new HIV cases were diagnosed in the past year alone. This sharp increase stands in stark contrast to the global trend where new cases have significantly decreased over the last decade.

Current estimates reveal that approximately one in every 60 adults in Fiji, a nation of about 900,000, is living with HIV. This marks a notable rise compared to five years ago when the rate was roughly one in 167.

The rapid spread of the epidemic in Fiji is fueled by a combination of behaviors, primarily unprotected sexual activity, low condom use, and a troubling rise in illegal drug use. The surge in intravenous methamphetamine use and needle-sharing has contributed to accelerating transmission rates.

Data from health authorities shows that injecting drug use accounts for more than 40% of new diagnoses where the transmission method is known, while sexual contact comprises the majority of the remaining cases.

Vulnerable infants are bearing a particularly heavy burden, with officials reporting many transmissions from mother to child over the past year. Alarmingly, about two out of every 100 pregnant women in Fiji are currently living with the virus.

Concerns from international and local health experts are mounting, particularly regarding Fiji’s inadequate diagnosis and treatment levels. Estimates from UNAIDS suggest that only 39% of people living with HIV in Fiji know their status, and a troubling 22% are receiving essential antiretroviral treatment.

“What worries me the most is the speed of the epidemic and how many people may be living with HIV without realizing it,” said Renata Ram, the Fiji adviser for UNAIDS. She added that the issue isn’t always a refusal for treatment; fear of being identified at an HIV clinic can deter people.

This disconnect between infection and treatment leaves many susceptible to opportunistic infections and worsening health, while also allowing for ongoing transmission in local communities. In fact, HIV-related deaths have increased, surpassing 100 fatalities in 2025, compared to just 25 a few years ago.

In light of the emergency, the Fijian government has announced plans for a comprehensive response involving a “whole-of-government” approach to revamp healthcare delivery.

Key initiatives include significantly expanding free rapid testing across the country, providing pre-exposure prophylaxis (PrEP) for high-risk groups, ensuring free access to antiretroviral medication for diagnosed individuals, and launching formal harm-reduction programs like needle and syringe exchanges.