Fiji Declares National HIV Emergency as Cases Surge

Published: 17 September 2026. The English Chronicle Desk. The English Chronicle Online

Fiji has declared a national HIV emergency after a sharp increase in infections raised concerns about the country’s ability to contain a rapidly changing epidemic. The Pacific island nation, home to fewer than one million people, is facing one of the fastest increases in new HIV infections recorded globally, according to UNAIDS.

The emergency declaration was announced by Fiji’s Minister for Health and Medical Services, Dr Ratu Atonio Lalabalavu, following a Cabinet decision earlier in September. The government says the scale of the increase now requires a coordinated national response involving health services, communities and other parts of government.

Fijian health authorities estimate that one in every 60 adults in the country is now living with HIV. The estimate represents a significant change from five years earlier, when the government estimated that roughly one in 167 adults was living with the virus. The health minister also said Fiji recorded 2,060 new HIV diagnoses in 2025 and that approximately one in 50 pregnant women is living with HIV.

UNAIDS has confirmed that Fiji is experiencing an unusually rapid increase in new HIV infections. According to the UN agency, new infections increased 12-fold between 2010 and 2025. An estimated 9,100 people were living with HIV in Fiji in 2025, but only 39% were aware of their status and just 22% were accessing antiretroviral treatment.

Those figures highlight one of the central challenges facing the country’s health system. The emergency is not simply about the number of new infections but also about identifying people who may not know they have HIV and connecting them with treatment and care.

UNAIDS says that among cases for which the mode of transmission is known, more than half were linked to sexual transmission, while more than 42% were associated with injecting drug use. The agency has therefore welcomed Fiji’s plans to strengthen prevention measures alongside testing and treatment services.

The increase has unfolded alongside growing concern about methamphetamine use and injecting drug use in Fiji. Health and public-health organisations have linked the country’s expanding drug problem with increased risks of HIV transmission, particularly where people who inject drugs lack access to sterile injecting equipment.

Fiji’s HIV response has already been under pressure for several years. UNAIDS reported in 2025 that the number of new HIV infections had risen sharply since 2014 and that the government had declared an HIV outbreak in January 2025. At that time, the country was also considering harm-reduction measures intended to reduce transmission among people who inject drugs.

The latest emergency declaration marks a further escalation in the government’s response. UNAIDS said Fiji has established a Cabinet subcommittee to address policy and implementation barriers and accelerate action. The government has also announced plans to expand HIV prevention, testing and treatment and improve access to medicines that can prevent HIV infection.

Among the measures receiving international attention is a planned needle and syringe programme. UNAIDS said legislative amendments are expected to be presented to Parliament to enable the programme. Such programmes are used internationally as a public-health measure to reduce transmission of blood-borne infections among people who inject drugs.

The government is also planning broader access to pre-exposure prophylaxis, commonly known as PrEP, including longer-acting prevention options. The strategy is intended to strengthen prevention alongside conventional testing, diagnosis and treatment.

UNAIDS Executive Director Winnie Byanyima welcomed the emergency declaration, saying the development demonstrated the need for health and community systems capable of responding quickly when HIV epidemics change. The agency has pledged continued support for Fiji as it expands its national response.

The UN agency has also stressed that the emergency declaration should be understood as a call for action rather than fear. HIV is not transmitted through ordinary everyday contact, and people receiving effective treatment who have an undetectable viral load do not sexually transmit the virus, according to UNAIDS.

That message is significant in Fiji, where health officials and community organisations have identified stigma and limited awareness as additional barriers to controlling the epidemic. People who do not know their HIV status cannot access treatment, while fear of discrimination can discourage individuals from seeking testing and medical support.

The treatment gap remains particularly important. UNAIDS estimates that fewer than one in four people living with HIV in Fiji were receiving antiretroviral treatment in 2025. Expanding treatment access is central not only to improving the health of people living with HIV but also to reducing onward transmission.

The country’s geographical position and connections across the Pacific add another dimension to the public-health challenge. Fiji is a regional hub for travel, education, employment and family links, meaning health authorities need to coordinate their response beyond individual communities.

UNAIDS has said that Pacific countries are at different stages of their HIV epidemics but that the region’s close connections make cooperation important. Shared expertise, surveillance, prevention programmes and community-led services can help governments identify emerging changes and respond earlier.

Community organisations are already playing an important role in Fiji’s response. UNAIDS has highlighted the work of community groups and peer outreach workers who help connect people with prevention, testing, treatment and care. These organisations can also help address misinformation and reduce stigma surrounding HIV.

The scale of the recent increase represents a major departure from Fiji’s earlier experience with the virus. For many years, HIV remained relatively limited in the country compared with some other regions. UNAIDS reported in 2025 that fewer than 500 people were estimated to be living with HIV in Fiji in 2014, compared with an estimated 5,900 people a decade later.

The latest estimate of 9,100 people living with HIV in 2025 indicates how quickly the situation has developed. At the same time, the difference between estimated infections and diagnosed cases underscores the importance of testing and surveillance.

The emergency declaration therefore comes with a broad set of challenges. Fiji must increase testing, improve access to treatment, strengthen prevention, address stigma and develop effective responses to the factors contributing to new infections. Health authorities must also ensure that pregnant women and children affected by the epidemic receive appropriate medical support.

For the government, the declaration creates an opportunity to bring together health services, community organisations and international partners under a more coordinated strategy. UNAIDS has said it will continue supporting Fiji with policy advice and connections to technical and development partners.

The international response is also likely to remain focused on whether the new measures translate into wider access to testing and treatment. Fiji’s experience demonstrates how quickly an HIV epidemic can change when prevention and health-system gaps overlap with other social and public-health pressures.

For now, officials are treating the situation as a national health priority rather than an isolated outbreak. The emergency declaration is intended to accelerate action, while the government’s planned expansion of prevention, testing and treatment seeks to slow new infections and reach people who remain unaware of their HIV status.

UNAIDS has said Fiji still has an opportunity to change the course of the epidemic. The immediate challenge will be turning that opportunity into sustained action across the country’s health system and communities, while ensuring that people living with HIV can obtain testing, treatment and support without discrimination.