Fiji Declares National HIV Emergency Amid Surging Infections
The island nation is implementing expanded testing and treatment programs to combat a significant increase in HIV cases, largely attributed to rising methamphetamine use.
Fiji has declared a national HIV emergency following an alarming surge in infections, with UNAIDS reporting that one in 60 adults in the South Pacific island nation now live with the virus. This marks a significant increase from five years ago when the infection rate was one in 167 adults.
The Fijian government is intensifying testing and treatment efforts to address the crisis, which has seen a 12-fold increase in new infections over the past 15 years. In 2025 alone, Fiji recorded over 2,000 new cases, a 16-fold rise compared to 2019. The epidemic's impact is starkly visible, with 59 infants born with HIV in 2025, and 18 of them succumbing to the virus before their first birthday.
Health officials attribute the surge primarily to a growing epidemic of injected drug use, particularly methamphetamine. As Fiji serves as a transit hub for illicit drugs moving towards Australia and New Zealand, local markets for substances like methamphetamine have expanded, leading to increased high-risk behaviors such as needle sharing among users. This practice is considered a major driver of the escalating HIV transmission rates.
Antonio Lalabalavu, Fiji's health minister, announced that the situation, initially labeled an outbreak in January 2025, now necessitates a comprehensive, government-wide response. The strategy focuses on providing support and care rather than judgment. Key initiatives include expanding free HIV testing, distributing clean needles to drug users, and offering free antiretroviral treatments. Currently, only 39% of diagnosed patients are receiving care.
International health organizations have expressed alarm over the rapid spread. Winnie Byanyima, executive director of UNAIDS, highlighted Fiji's situation as one of the sharpest increases in new HIV infections globally, underscoring that the AIDS epidemic is far from over. Regional health directors also warned that Fiji's status as a major transport and tourism hub could facilitate the spread of HIV to other South Pacific nations if swift, stigma-reducing actions are not taken.
A rapid assessment by the World Health Organization (WHO) in December identified unsafe injecting practices as a significant risk factor. The report noted a disturbing trend known as the "Bluetooth trend," where individuals inject blood from an already intoxicated person to achieve a high when unable to afford their own drugs, further increasing HIV transmission risks. The assessment found that 50% of interviewed participants had injected themselves with a potentially contaminated syringe, with crystal methamphetamine being the most commonly used drug.
In 2024, 1,583 new HIV cases were reported, and 1,226 cases were identified in the first six months of 2025. Munkhtuya Altangerel, UN Development Programme representative, described the epidemic as a development and human rights challenge that threatens lives, communities, and progress, urging decisive action to scale up harm reduction and expand access to testing and treatment services.