Fiji Declares HIV Emergency as Infections Surge
Fiji has declared HIV a national health emergency after a sharp rise in infections. The declaration was made by Health and Medical Services Minister Dr Ratu Atonio Lalabalavu following a cabinet decision on 9 September. The Guardian
The government estimates one in every 60 adults in Fiji is now living with HIV, up from one in 167 five years ago. Fiji recorded 2,060 new HIV diagnoses in 2025.
UNAIDS said new HIV infections in Fiji rose 12-fold between 2010 and 2025. The agency estimates 9,100 people were living with HIV in Fiji in 2025. UNAIDS
On testing and treatment, of people living with HIV in 2025, only 39% knew their status, according to the UN. Only 22% were taking antiretroviral treatment, medicines that suppress the virus. That leaves most infections undiagnosed and most known infections untreated, with transmission continuing through multiple routes. Think of the care path as a chain of steps from test to treatment.
Among cases with a known mode of transmission, over half were linked to sexual transmission and more than 42% to injecting drug use, according to UNAIDS. One in 50 pregnant women in Fiji has HIV. The rise has been described as an "extraordinary increase" largely fueled by a methamphetamine epidemic. CNN
The emergency declaration strengthens the whole-of-government response to the outbreak, the government said. UNAIDS welcomed Fiji's plans to introduce a needle and syringe programme, which supplies clean equipment to lower spread, with legislative amendments expected to go before parliament.
The broader context here is a shift from concentrated pockets to wider spread. A 12-fold rise over 15 years, with 1 in 60 adults and 1 in 50 pregnant women living with HIV, points to ongoing transmission rather than better detection alone. Low awareness suggests testing has not kept pace, and low treatment suggests gaps in linking people to care and keeping them in it.
Looking at what this means for policy, the emergency framing does two things at once. It centralizes coordination across health, justice and social sectors. It also creates political cover for harm reduction. Needle and syringe programmes remain legally and socially sensitive in much of the Pacific, so moving amendments through parliament will test whether the emergency can turn intent into law, supplies and frontline delivery.
In my view, the next variables to watch are diagnostic yield, antenatal screening and preventive medicine uptake, and starting treatment. Without rapid expansion of testing, early treatment, viral suppression and prevention of transmission from parent to child, prevalence will keep climbing. Fiji's declaration sets the mandate. Delivery will depend on supply chains, health workers, outreach to people who inject drugs, and steady surveillance of whether new infections stabilize.
