Fiji declares national HIV crisis as new cases spike
Fiji has declared a national HIV emergency after a surge in new cases, with the government and international agencies racing to contain a crisis driven by sexual transmission and injection drug use.
Fiji has declared a national HIV crisis as sexual transmission and illicit drug use help to spread the virus, now infecting an estimated one in 60 adults in the Pacific nation, up from one in 167 five years earlier.
“I am formally declaring a national HIV emergency in Fiji,” Health Minister Atonio Lalabalavu told reporters on Wednesday. “This decision recognises the seriousness of the epidemic and the urgent, coordinated response our country now needs.”
New HIV diagnoses surged to 2,016 cases in 2025 — 16 times the level recorded in 2019, authorities said, vowing a “whole of government” response.
Among HIV cases with a known mode of transmission, more than half were linked to sexual transmission and more than 42% to injecting drug use, the Joint United Nations Programme on HIV/AIDS (UNAIDS) said in a press release on Wednesday.
HIV transmission rates began to increase around 2019 when a group of “very high-risk” injecting drug users emerged, primarily in the sex worker community, Renata Ram, United Nations’ HIV/AIDS country director in Fiji, told AFP earlier this year.
Two in every 100 pregnant women carry the virus, and of the 59 babies born with HIV in 2025, 18 died before their first birthday, as HIV can be transmitted to the fetus or the newborn during pregnancy, during labour or delivery, or by breastfeeding.
Scaling up efforts
The government said it was expanding access to free HIV testing, prevention services and treatment.
“This includes rapid testing, prevention medicine for people at higher risk, harm-reduction measures for people who inject drugs, and free treatment for people diagnosed with HIV.”
Fiji said it was receiving external support in the effort, including from Australia, New Zealand, India, the Global Fund and the United Nations.
“Fiji has recognized the urgency of the moment and is stepping up its response,” said Winnie Byanyima, executive director of the in a press release, adding that the current situation is a reminder to the world that AIDS is not over.
“HIV epidemics can change quickly, and countries need health and community systems that are ready to respond urgently,” she said.
The UN agency welcomed Fiji's plans to introduce legislation for a needle and syringe programme.
“Fiji still has an opportunity to change the course of this epidemic,” said Eamonn Murphy, UNAIDS director for regions including Asia and the Pacific.
He added that the national crisis declaration is a call for action, not fear. “HIV is not transmitted through everyday contact, and people on effective treatment with an undetectable viral load do not sexually transmit HIV,” Murphy said.
He called for stronger cooperation across the Pacific and sustained international solidarity to reinforce the national effort and help accelerate action.
A hub for regional drug trafficking
The roots of the crisis lie partly in Fiji’s position as a drug trafficking hub. Pacific islands, including Fiji, have been transit hubs for drugs from Latin America and Asia destined for lucrative markets in Australia and New Zealand.
The flow of highly addictive drugs such as methamphetamine and cocaine rose sharply after a lull during the COVID-19 pandemic, according to the Global Initiative Against Transnational Organized Crime.
Those drugs are increasingly seeping into the Pacific's domestic markets — in part due to foreign criminal syndicates opting to pay their local facilitators in kind.
