Fiji declares a national emergency as HIV cases skyrocket
Zane Irwin
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Fiji has declared a national crisis amid an extraordinary rise of HIV cases, with health officials raising the alarm about an epidemic that has emerged alongside an increase in injectable drug use.
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Fiji, a Pacific island nation of less than 1 million people, recorded more than 2,000 new HIV cases in 2025 – 16 times as many as in 2019, the government said in an official statement on Sept 15.
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One in 60 adults on the archipelago is living with the virus that causes AIDS, the government estimated.
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UNAIDS, a United Nations programme, said in a statement on Sept 16 that it was “one of the sharpest increases in new HIV infections globally”.
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Winnie Byanyima, the executive director of UNAIDS, added that Fiji’s epidemic was “a stark reminder to the world that AIDS is not over”.
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The outbreak is not limited to particular areas or populations, health officials warned.
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And because the nation serves as a regional hub for business, tourism and transport, the surge in cases could affect other countries in the South Pacific if left unchecked.
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That inter-connectedness may have contributed to the soaring rates of infection, said Eamonn Murphy, the director of regional support teams in the Asia Pacific region, Central Asia and Eastern Europe for UNAIDS.
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An influx of drugs on the islands during the Covid-19 pandemic added “fuel on the flame” to a long-standing, but low-level, HIV presence in Fiji, Murphy said.
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The country is a key example in a growing trend of Pacific island nations “caught in the middle of illicit smuggling routes”, according to a 2024 UN report.
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As substances like methamphetamine and cocaine pass through Fiji and other island nations on their way to Australia and New Zealand, the report said, those nations have emerged as drug markets, not just way stations.
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Fiji is also one of several global hot spots where a dangerous trend called “bluetoothing”, in which people inject themselves with the blood of other drug users to get a cheap high, is contributing to spikes in HIV rates.
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Health officials say they believe that drug use is a key driver of Fiji’s epidemic.
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A December report by the World Health Organization and UN Development Programme found that nearly half of the HIV patients with available information about their exposure had injected drugs, primarily crystal methamphetamine.
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“Fiji was off the map in terms of HIV,” Murphy said.
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But in recent years, the virus has spread throughout the country, heavily affecting young men but also raising mortality rates among children and babies born to infected women.
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In its statement on Sept 15, the government said that 59 infants were born with HIV in 2025, with 18 of them dying before their first birthday.
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Fiji’s government has ramped up testing and treatment efforts since January 2025, when the nation declared an HIV outbreak.
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But “an outbreak-level response is no longer sufficient”, Atonio Lalabalavu, the nation’s health minister, said in a video statement posted on Sept 15.
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Fiji pledged a “whole-of-government response”, including expanded access to free testing, prevention services and treatment, as well as harm-reduction measures such as programmes that allow people who inject drugs to exchange used needles for clean ones.
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Murphy praised the government’s efforts, but said community leaders and the religious authorities would have to help combat the stigma around drug use and misunderstandings about HIV and its treatments.
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“They really need to move fast,” he said.
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The Aporia
