Fiji has declared a national HIV emergency after a sharp rise in new infections, prompting the government to step up testing, prevention and treatment programmes amid concerns over the growing role of injecting drug use and methamphetamine consumption in the spread of the virus.
Health and Medical Services Minister Ratu Atonio Lalabalavu announced the emergency declaration this week, saying the scale of the outbreak required a response beyond the measures normally used to contain an HIV outbreak. The decision followed a Cabinet meeting on September 9 and is intended to bring government agencies and other organisations together to accelerate efforts to control the epidemic.
Government estimates indicate that about one in every 60 adults in Fiji is now living with HIV, a substantial increase from an estimated one in 167 five years ago. The country recorded 2,016 newly diagnosed HIV cases in 2025, the highest annual figure recorded, representing a 27% increase from 1,583 cases in 2024. Fiji’s Health Ministry has also cautioned that the rise reflects both increasing infections and improvements in testing and surveillance, which have helped identify cases that may previously have gone undetected.
The increase has placed particular pressure on Fiji’s health system because of gaps in awareness, testing and access to treatment. UNAIDS estimates that about 9,100 people were living with HIV in Fiji in 2025, but only 39% were aware of their HIV status and just 22% were receiving antiretroviral treatment. The UN agency has described Fiji as experiencing one of the sharpest increases in new HIV infections globally, estimating that new infections rose 12-fold between 2010 and 2025.
Health authorities are also concerned about the impact on pregnant women and children. Government estimates suggest that about one in 50 pregnant women in Fiji is living with HIV. Official figures show that 59 babies were born with HIV in 2025, while 18 died before reaching their first birthday. The figures have added urgency to efforts to expand testing and treatment for pregnant women and reduce transmission from mothers to their children.
Drug use has emerged as an important factor in the country’s changing HIV landscape. According to UNAIDS, among cases where the mode of transmission was known, more than half were associated with sexual transmission while more than 42% were linked to injecting drug use. Authorities and international health organisations have raised concerns about the increasing use of methamphetamine and the sharing of injecting equipment, particularly where sterile needles and syringes are difficult to obtain.
Fiji’s position along drug-trafficking routes in the Pacific has also contributed to concerns about the availability of illicit drugs. The increased movement and local consumption of methamphetamine has coincided with a rise in injecting drug use, creating additional challenges for public health authorities attempting to reduce HIV transmission.
As part of its emergency response, the Fijian government plans to expand free, voluntary and confidential HIV testing and improve access to treatment and preventive medicines. Officials are also looking at wider availability of pre-exposure prophylaxis, or PrEP, which can reduce the risk of acquiring HIV, as well as longer-acting prevention options.
Another major measure under consideration is the introduction of a needle and syringe programme. UNAIDS has welcomed plans to establish such a programme, with legislative amendments expected to be considered by Fiji’s parliament. The initiative is intended to provide people who inject drugs with sterile equipment and reduce transmission associated with the sharing of contaminated needles.
The government has also established a five-minister Cabinet subcommittee to identify and address policy and implementation barriers. Officials say the response will involve not only the health sector but also community organisations and other government agencies.
UNAIDS Executive Director Winnie Byanyima welcomed Fiji’s decision to declare the emergency, saying the development demonstrated the need for health and community systems to respond quickly when HIV epidemics change. The agency has said it will continue supporting Fiji with policy advice, technical assistance and coordination with community and international partners.
Despite the alarming figures, health agencies have stressed that HIV is preventable and treatable and that people living with the virus should not face discrimination. UNAIDS has also emphasised that HIV is not transmitted through ordinary everyday contact and that people receiving effective treatment who have an undetectable viral load do not sexually transmit the virus. Fiji’s government has reiterated that discrimination against people living with HIV is illegal.
The emergency declaration therefore represents an effort to expand the country’s response at a time when infections are increasing rapidly. Authorities are now seeking to improve early diagnosis, ensure more people receive treatment, expand prevention services and strengthen harm-reduction measures. The response will also need to address stigma and misinformation, which health organisations say can discourage people from seeking testing and treatment.
With a population of less than one million, Fiji’s rapidly changing HIV situation has attracted wider attention across the Pacific. UNAIDS has described the country’s experience as a reminder that HIV epidemics can change quickly and that sustained investment in prevention, testing, treatment and community-based services remains essential.
