Fiji has declared a national health emergency after a sharp rise in HIV diagnoses, with the government now estimating that one in 60 adults on the islands is living with the virus, up from one in 167 just five years ago.
A Fast-Moving Epidemic
Health and medical services minister Dr Ratu Atonio Lalabalavu said the emergency declaration reflects an epidemic that has outpaced the country's outbreak-level response. Reported figures vary slightly by outlet, but the trend is unmistakable: one report puts 2025's new diagnoses at 2,060, another at 2,016, describing it as sixteen times the number recorded in 2019. Fifty-nine babies were born with HIV, and one in 50 pregnant women in Fiji now has the virus. Adult prevalence has reportedly reached 1.6 percent, a threshold public health officials use to define a generalized epidemic, meaning the virus is spreading well beyond high-risk groups.
What's Driving It
Experts link the surge to unsafe sex, needle sharing and a practice known as "bluetoothing" or "hotspotting," in which people who inject drugs share blood directly. Fiji has become a hub for methamphetamine trafficking toward Australia and New Zealand, fueling a rise in injection drug use. Stigma compounds the problem: reporting suggests only around 39 percent of people living with HIV in Fiji know their status, and roughly 22 percent are on antiretroviral treatment, even though effective treatment eliminates sexual transmission risk.
Today I am formally declaring a national health emergency in Fiji. This decision recognises the seriousness of the epidemic and the urgent coordinated response our country now needs.
Dr Ratu Atonio Lalabalavu
The Response
Fiji's government plans to expand prevention, testing and treatment, including wider PrEP access and long-acting, twice-yearly injectable options. Legislative amendments are expected before parliament to establish a needle and syringe program aimed at reducing transmission among people who inject drugs. Australia, New Zealand, India, the Global Fund and the United Nations have voiced support, and UNAIDS has welcomed the declaration.
Why It Matters
Fiji's outward migration to Australia and New Zealand, much of it through labor mobility schemes, means an unchecked outbreak carries risk for the wider Pacific. It's a sobering reminder that HIV's global fight is far from finished, and that the community-led, stigma-fighting playbook LGBTQ+ organizers built decades ago is still the model the world reaches for when a crisis like this hits.
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.
Eamonn Murphy, UNAIDS
Fiji had made real progress: interventions between 2014 and 2021 reportedly pushed the epidemic's reproductive rate below one. That the trend has since reversed underscores how quickly gains can erode without sustained investment and destigmatized care.
Sources: Attitude, PinkNews, The Advocate
Cover photo: Jan van der Wolf / Pexels
