Fiji declares national HIV emergency as Pacific nation grapples with surge in cases

Fiji has declared a national HIV emergency amid a spike in infections as the Pacific nation grapples with a correlating rise in methamphetamine use.

The country’s health and medical services minister, Dr Ratu Atonio Lalabalavu, said in a statement on social media that an outbreak-level response was no longer sufficient to address what he described an “epidemic”.

“Today I am formally declaring a national health emergency in Fiji,” he said. “This decision recognises the seriousness of the epidemic and the urgent coordinated response our country now needs.”

The health minister said the government estimates that one in every 60 adults in Fiji is now living with HIV.

“Five years ago, the estimate was one in 167. In 2025, we recorded 2,060 new HIV diagnoses,” he said, adding that one in 50 pregnant women has HIV.

The emergency declaration followed on from a cabinet decision on 9 September and would require a coordinated response, he added.

Home to less than one million people, the Pacific nation is facing one of the sharpest increases in new HIV infections globally, according to UNAIDS, which said that new infections spiked 12-fold between 2010 and 2025.

Fiji’s location as a drug-running hub coupled with the escalating use of methamphetamine locally has fuelled the rapid spread of HIV, a situation worsened by unsafe injecting and a lack of access to clean needles. Low health awareness, cultural stigma and inadequate testing and treatment have exacerbated the crisis.

Among HIV cases in Fiji with a known mode of transmission, over half were linked to sexual transmission and more than 42% to injecting drug use, according to UNAIDS.

Of an estimated 9,100 people living with HIV in Fiji in 2025, only 39% were aware of their HIV status and only 22% were accessing antiretroviral treatment, the UN said.

Responding to the emergency declaration, UNAIDS executive director Winnie Byanyima said in a statement on Wednesday that the situation was a “a stark reminder to the world that AIDS is not over”.

“HIV epidemics can change quickly, and countries need health and community systems that are ready to respond urgently,” said Byanyima. “Fiji has recognised the urgency of the moment and is stepping up its response.”

The UN agency said it welcomed plans to introduce a needle and syringe programme, with legislative amendments expected to go before parliament, as well as efforts to expand prevention, testing and access to treatment.