Fiji has declared a national HIV emergency after the government estimated that one in 60 adults is living with the virus, up from one in 167 five years ago. Health minister Hon Ratu Atonio Lalabalavu said this week that an outbreak-level response was no longer sufficient.

The island nation of about 900,000 people recorded 2,016 new diagnoses in 2025. Cabinet backed the declaration and formed a subcommittee to speed decisions. Prime Minister Sitiveni Rabuka supported the step.

Diagnoses Climb as the Epidemic Spreads

Health officials said last year's 2,016 diagnoses were 27 per cent higher than 1,583 in 2024 and about 16 times the 2019 figure.

Fiji declared an HIV outbreak in January 2025 after wider testing uncovered cases that had gone unseen. UNAIDS said new infections rose 12-fold between 2010 and 2025, one of the sharpest increases recorded anywhere.

Among cases with a known route, more than half were tied to sexual transmission and more than 42 per cent to injecting drug use.

Rising injecting drug use, including methamphetamine use, and limited access to sterile injecting equipment have contributed to the increase, health authorities say. Fifty-nine babies were born with HIV in 2025 and 18 died before their first birthday, the government reported.

Prevalence among women attending antenatal care has reached about two per cent, meaning roughly one in 50 pregnant women tested at clinics has HIV. Lalabalavu said the figures show the response must reach further. The minister added that a diagnosis does not take away a future if treatment is maintained.

UNAIDS estimates that 9,100 people lived with HIV in 2025, yet only 39 per cent knew their status and 22 per cent were on treatment. Adult prevalence is now estimated at around one in 60.

Testing, Treatment and Harm Reduction

Authorities plan wider free, voluntary and confidential testing, pre-exposure prophylaxis including long-acting injections, and a formal needle and syringe programme after legal changes go to parliament.

Fiji's nationally led response is receiving support from Australia, New Zealand, India, the Global Fund and UN agencies. Authorities have also set up a dedicated sexual and reproductive health and HIV unit to run the national outbreak response, expand testing and keep people on treatment.

UNAIDS executive director Winnie Byanyima said: 'Fiji has recognized the urgency of the moment and is stepping up its response. It is also a stark reminder to the world that AIDS is not over.'

Stigma Still Slows Access to Care

Lalabalavu said no one should be ashamed, threatened or excluded because of their HIV status, adding that stigma drives people from services that can help them.

He called on families, faith leaders, schools and employers to encourage testing and keep people in care. The epidemic is no longer limited to people who inject drugs.

Fiji's links with other Pacific countries through travel, employment, education and family ties also give the response a regional dimension, UNAIDS said. Parliament is being asked to consider a standing committee on HIV while clinics keep expanding screening after more than 92,000 tests last year.

Partners say neighbouring countries are linked by travel, so faster harm reduction in Fiji will matter beyond its shores.

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