Fiji's HIV Emergency: How a Drug-Driven Outbreak Spread
Fiji has declared HIV a national emergency, with about one in 60 people living with the virus.
Health Minister Dr Atonio Lalabalavu announced the declaration, according to a Sept. 15 government statement. International reporting on Sept. 16 confirmed the designation. CNN The increase is linked in large part to a methamphetamine epidemic. An estimated 9,000 Fijians were living with HIV as of March 2026. RNZ
This emergency follows an earlier step. In early 2025, Fiji declared a national HIV outbreak and adopted a National Outbreak Response Plan for HIV. Ministry of Health The Health Ministry aims to end the AIDS epidemic by 2030.
The figures behind the 2025 declaration counted 1,093 new HIV cases between January and September in the year before January 2025, and the country met the definition for a national outbreak. Over the last 25 years, HIV incidence, the rate of new cases, rose from 0.7 to 7 per 100,000 people, according to the Ministry of Health.
In January 2025, the outbreak was reported mainly among people who inject drugs. Health Policy Watch UNAIDS now estimates adult HIV prevalence, the share of adults living with the virus, in Fiji at 1.6%. Doherty Institute Fiji is described as having the world's fastest-growing HIV epidemic.
On treatment, 22% of people living with HIV in Fiji are on treatment. That means antiretroviral therapy, daily medicine that keeps the virus under control. Among those on treatment, only 3.2% have undetectable viral loads, meaning the amount of virus in the blood is so low tests cannot find it. Like a firebreak that stops a fire from spreading, reaching that level stops onward transmission.
The broader context here is that Fiji's control strategy faces pressure on two fronts at once. The plan depends on finding cases, linking people to antiretroviral therapy, supporting daily use, and keeping virus levels low enough to slow further spread. In Fiji, treatment coverage and suppression are far below the levels needed for control across the population, while transmission has moved beyond the first affected group into wider spread. For officials focused on Pacific health security, the move from concentrated cases among people who inject drugs to national outbreak to national emergency in less than two years shows how fast injection-driven transmission can grow when harm reduction, testing and steady treatment fall short. What comes next depends on whether emergency powers allow larger procurement, more staffing and wider community outreach than the 2025 plan achieved.
