Fiji declares national HIV emergency as adult infections reach one in 60

Emergency declaration and infection surge

Fiji declared a national public health emergency on 16 September 2026 after health data revealed a rapid rise in HIV infections across the archipelago. The South Pacific nation of over 900,000 residents recorded 2,016 new HIV diagnoses in 2025, representing a 27% increase over the previous year and a 16-fold jump compared to 2019 levels. An estimated 9,100 people across the country now live with the virus, placing the adult infection rate at one in every 60 people, compared to one in 167 recorded five years ago. Health officials confirmed that UNAIDS ranks Fiji among the countries with the fastest-growing HIV infection rates globally. Health Minister Atonio Lalabalavu announced the emergency designation during an address to reporters.

I formally declare an HIV national emergency in Fiji. This decision recognizes the seriousness of the epidemic and the urgent and coordinated response our country now needs.

Transmission drivers and illicit drug trade

Data on known transmission routes indicates that sexual contact accounts for over half of all cases, while more than 42% stem from contaminated needles used in drug injection. The surge in cases follows the expansion of illicit drug transit routes running through the Pacific. Fiji serves as a transshipment hub connecting drug suppliers in Latin America and Asia to consumer markets in Australia and New Zealand. Smuggling syndicates have increasingly compensated local facilitators with illicit narcotics rather than cash, flooding the domestic population with methamphetamine. UNAIDS Fiji representative Renata Ram noted that the upward trend in infections started around 2019, driven by an emerging high-risk demographic of injection drug users concentrated among sex workers.

Gaps in testing and maternal health

Public health metrics demonstrate low rates of diagnosis and medical intervention across the island nation. UNAIDS data shows that only 39% of people living with HIV in Fiji know their positive status, and just 22% receive antiretroviral treatment. Vertical transmission from mother to child has also escalated, with two in every 100 pregnant women in Fiji carrying the virus. In 2025, 59 infants were born with HIV, and 18 of them died before reaching their first birthday. Effective antiretroviral therapy reduces viral loads to undetectable levels, which prevents transmission during sexual intercourse and childbirth.

Government response and international support

In response to the crisis, the Fijian government formed a five-member cabinet subcommittee tasked with eliminating institutional barriers to healthcare delivery. The administration plans to introduce legislative changes in parliament to support harm-reduction initiatives, including free needle and syringe distribution programs for drug users. The national strategy also expands access to voluntary confidential rapid testing, preventive medication for high-risk individuals, and free antiretroviral treatment for all confirmed cases. Financial and logistical support is being provided by Australia, New Zealand, India, the Global Fund, and United Nations agencies. UNAIDS Regional Director Eamonn Murphy urged coordinated regional solidarity to support the national rollout.

Fiji still has a chance to turn the tide of this epidemic.