Fiji's health minister has formally declared a national HIV emergency, as the Pacific nation grapples with a sharp rise in infections driven by sexual transmission and injecting drug use. The announcement on Wednesday came as authorities revealed that new diagnoses reached 2,016 in 2025 — a sixteenfold increase compared with 2019.
“I am formally declaring a national HIV emergency in Fiji,” Health Minister Atonio Lalabalavu told reporters. “This decision recognises the seriousness of the epidemic and the urgent, coordinated response our country now needs.”
The scale of the crisis is stark: an estimated one in 60 adults in Fiji now carries the virus, up from one in 167 five years earlier. Among cases with a known mode of transmission, more than half were linked to sexual contact and more than 42% to injecting drug use, according to the Joint United Nations Programme on HIV/AIDS (UNAIDS).
A crisis rooted in drug trafficking
The surge began around 2019, when a group of “very high-risk” injecting drug users emerged, primarily within the sex worker community, Renata Ram, UNAIDS country director in Fiji, told AFP earlier this year. The country's position as a transit hub for drugs from Latin America and Asia — destined for markets in Australia and New Zealand — has compounded the problem. The flow of methamphetamine and cocaine rose sharply after a lull during the COVID-19 pandemic, according to the Global Initiative Against Transnational Organized Crime.
The impact on maternal and child health is particularly alarming. Two in every 100 pregnant women in Fiji carry the virus, and of the 59 babies born with HIV in 2025, 18 died before their first birthday. HIV can be transmitted from mother to child during pregnancy, labour, delivery, or breastfeeding.
Government response and international support
The government has pledged a “whole of government” response, expanding access to free HIV testing, prevention services, and treatment. This includes rapid testing, preventive medicine for those at higher risk, harm-reduction measures for people who inject drugs, and free treatment for those diagnosed with HIV.
Fiji is receiving external support from Australia, New Zealand, India, the Global Fund, and the United Nations. Winnie Byanyima, executive director of UNAIDS, welcomed the declaration, saying it shows Fiji has “recognized the urgency of the moment and is stepping up its response.” She added that the situation is a reminder that “AIDS is not over” and that “HIV epidemics can change quickly, and countries need health and community systems that are ready to respond urgently.”
UNAIDS also welcomed Fiji's plans to introduce legislation for a needle and syringe programme. Eamonn Murphy, UNAIDS director for Asia and the Pacific, stressed that the declaration is “a call for action, not fear.” He noted that “HIV is not transmitted through everyday contact, and people on effective treatment with an undetectable viral load do not sexually transmit HIV.”
Murphy called for stronger cooperation across the Pacific and sustained international solidarity to reinforce national efforts. The crisis in Fiji echoes broader challenges in the region, where health systems are often stretched and vulnerable to sudden outbreaks. As the world watches, the effectiveness of Fiji's response could offer lessons for other island nations facing similar pressures.
