Fiji has declared a national HIV emergency in response to a significant and rapid rise in infections, driven in part by increased methamphetamine use and injectable drug practices. The Pacific island nation, home to fewer than one million people, recorded more than 2,000 new HIV cases in 2025—a sharp increase from previous years—with government estimates indicating that one in every 60 adults is now living with the virus.
Health and Medical Services Minister Dr. Ratu Atonio Lalabalavu announced the emergency declaration on September 15, stating that an outbreak-level response was no longer sufficient and emphasizing the need for a coordinated, whole-of-government approach. The declaration followed a cabinet decision made earlier in the month. The government also reported that one in 50 pregnant women in Fiji is living with HIV, and that 59 infants were born with the virus in 2025, with 18 dying before their first birthday.
Fiji’s surge in HIV cases is among the sharpest increases worldwide, according to UNAIDS. The United Nations program highlighted the country’s growing epidemic as a reminder that HIV/AIDS remains a global challenge. UNAIDS Executive Director Winnie Byanyima welcomed Fiji’s announcement, underscoring the necessity of urgent health and community responses alongside expanded prevention, testing, and treatment efforts.
Experts point to several factors contributing to the rapid spread of HIV in Fiji. The nation’s role as a regional hub for business, tourism, and transportation has increased its connectivity and exposure to drug trafficking routes, particularly for methamphetamine and cocaine. This has intensified the local drug market, with injectable drug use identified as a major factor in HIV transmission. Unsafe practices, including “bluetoothing”—where individuals inject themselves with the blood of other drug users to achieve a high—have further accelerated infection rates.
UNAIDS estimates that among known modes of transmission, more than half of recent HIV cases in Fiji are attributed to sexual contact, while over 42% are linked to injecting drug use. A 2025 UN report noted that only 39% of the estimated 9,100 people living with HIV in Fiji were aware of their status, and only 22% were receiving antiretroviral treatment, indicating significant gaps in testing and care.
Fiji’s government has responded by expanding access to free HIV testing, prevention services, and treatment while planning to introduce harm-reduction initiatives, including needle and syringe exchange programs. Legislative proposals to support these measures are expected to be presented to parliament. However, authorities acknowledge that addressing stigma—particularly surrounding drug use—and increasing health awareness are critical to controlling the epidemic. Community and religious leaders have been called upon to assist in these efforts.
UN officials and local health experts warn that without rapid and sustained intervention, the HIV epidemic in Fiji could have broader regional implications, given the nation's interconnectedness with neighboring Pacific countries. The declaration of a national emergency marks a pivotal step in acknowledging and addressing the evolving public health crisis.