Fiji has formally declared HIV a national emergency following what officials describe as one of the sharpest increases in new infections globally. The declaration, made on 15 September, comes as new statistics indicate that one in 60 adults in the country are now living with the virus, a significant rise from one in 167 people five years ago.
Jason Mitchell, the head of Fiji’s HIV epidemic response, has characterized the situation as the fastest-growing HIV epidemic in the world. He cautioned that it could take between five and 10 years to bring the epidemic under control and expects infection numbers to continue rising in the interim.
Impact on Children and Mothers
Health officials are reporting a critical rise in mother-to-child transmission. In 2025, 59 babies were born with HIV at Colonial Memorial Hospital, Fiji’s largest medical facility; 18 of those infants died before their first birthday.
The crisis also extends to older children. Dr Kesaia Tuidraki, country director of Medical Services Pacific, reported that in a recent mobile clinic screening of 97 people in downtown Suva—mostly teenagers—one in six tested positive. Tuidraki emphasized the severity of the crisis, stating, Children are suffering, children are dying, and if that doesn’t move you I don’t know what will
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Drivers of the Epidemic
The surge is heavily linked to a domestic methamphetamine crisis. More than 42% of new cases in 2025 resulted from sharing contaminated needles or equipment. Medical workers report a shift from smoking the drug to injecting it, while some communities have reported children as young as nine injecting drugs. Dr Sailsosi Soko noted a dangerous practice where one person injects the drug and another subsequently injects that person’s blood.
Sexual transmission accounted for approximately half of new cases in 2025. New diagnoses are highest among those aged 15 to 34, with two-thirds of all cases involving people between the ages of 20 and 34. A 2021 survey found that among those aged 15 to 49 with multiple sexual partners, only 9% of women and 24% of men used a condom during their last sexual encounter.
Treatment Barriers and Response Strategy
Despite free access to testing and treatment, significant gaps in care remain. UNAIDS estimates that 9,100 people were living with HIV in Fiji in 2025—a 12-fold increase since 2010—yet only 39% of those individuals knew their status. Only 22% of people living with HIV are receiving antiretroviral treatment.
Officials attribute these gaps to social stigma and logistical barriers, such as transportation costs and the need for multiple consultations. The government’s response includes several key initiatives:
- Needle and Syringe Programme: The government plans to introduce a program to distribute sterile needles, with Jason Mitchell expecting a change to the HIV Act to be passed within two weeks to allow public health workers to do so.
- Expanded Prevention: New measures include expanding access to pre-exposure prophylaxis (PrEP) and harm reduction for people who inject drugs.
Regional Implications
The crisis has prompted neighboring nations to increase their own preparedness. The Samoa Health Ministry is currently strengthening its national HIV response and urging citizens to use condoms and avoid sharing needles, though it clarified that Samoa is not experiencing the same situation as Fiji.
Dr Mark Jacobs, WHO Representative to the South Pacific, stressed that whole-of-government and whole-of-society collaboration is necessary to manage the emergency, noting that modern treatments allow people living with HIV to live healthy lives and prevent further transmission.
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