Fiji has declared a national health emergency to combat a rapidly growing HIV epidemic, with government estimates indicating that one in 60 adults in the Pacific island nation is now living with the virus. Health Minister Dr. Ratu Atonio Lalabalavu formally announced the emergency on Sept. 15, stating that an outbreak-level response
was no longer sufficient to address the crisis.
Fiji Declares National HIV Emergency Amid Surge in New Infections
The declaration follows a cabinet decision made on Sept. 9 and escalates a previous HIV outbreak announcement from January 2025. According to the Ministry of Health and Medical Services, Fiji recorded 2,016 new HIV diagnoses in 2025, the highest annual total since national surveillance began. This figure represents a 27% increase over 2024.
The surge is particularly acute among young adults. Ministry data shows that people aged 20 to 34 represented 66.9% of 2025 diagnoses, with those aged 20 to 24 alone accounting for 32%.
Drivers of the Epidemic and Transmission Routes
Health officials and UNAIDS have linked the spike in infections to Fiji’s role as a drug-running hub and a correlating rise in local methamphetamine use. The rapid spread has been fueled by unsafe injecting practices and a lack of access to clean needles.
Among cases where the transmission route was identified, 50.6% were linked to sexual transmission and 42.6% to injecting drug use. Experts have specifically highlighted “bluetoothing” or “hotspotting”—the practice of injecting the blood of already intoxicated individuals—as a driver of the surge. This practice is often used to obtain a cheaper high or to circumvent the difficulty of acquiring syringes in Fiji.
The crisis is also impacting maternal and infant health. HIV prevalence among women receiving antenatal care has reached approximately 2%, or one in 50. In 2025, 59 babies were born with HIV, and 18 died before their first birthday.
Treatment Gaps and Healthcare Strain
Despite the rise in cases, significant gaps remain in testing and treatment. UNAIDS estimates that of the 9,100 Fijians living with HIV in 2025, only 39% were aware of their status and only 22% were receiving antiretroviral treatment. This contrasts sharply with the global average, where 78% of people with HIV access treatment.
The Ministry of Health reported that 41.9% of the 2,016 people diagnosed in 2025 were not enrolled in care at the time of analysis. Additionally, 36% of patients with available immune system test results already had advanced HIV disease at the time of diagnosis.
Jason Mitchell, leader of the national HIV response taskforce, stated that the epidemic has put clinical services under significant pressure, as patients who could be well with treatment are instead occupying hospital beds. Mitchell believes it may take upwards of five years to get on top of the epidemic.
Government Response and Prevention Plans
To manage the crisis, the government has established a five-minister Cabinet subcommittee to remove barriers to action. Planned interventions include:
- Needle and Syringe Programme: The government plans to introduce a formal programme for drug users, with legislative amendments expected to be presented to Parliament. Minister Lalabalavu noted that the country already possesses sufficient supplies of needles and syringes.
- Expanded Prevention: Authorities intend to widen access to free, voluntary, and confidential testing, as well as pre-exposure prophylaxis (PrEP).
- Harm Reduction: The government is expanding harm-reduction services and treatment for injecting drug users.
UNAIDS Executive Director Winnie Byanyima welcomed the emergency declaration, stating it signals the urgency needed to ramp up the response. Byanyima noted that the situation serves as a stark reminder to the world that AIDS is not over
.
Minister Lalabalavu has urged the public to seek testing, emphasizing that discrimination against people living with HIV is illegal and that stigma often drives individuals away from essential services.
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