Fiji Declares National HIV Emergency as Infections Surge, Government Expands Testing and Treatment
Fiji has declared a national HIV emergency after a sharp rise in infections pushed the Pacific island nation into what health authorities describe as a critical stage of the epidemic. Health Minister Ratu Atonio Lalabalavu announced the emergency declaration this week, saying the previous outbreak-level response was no longer sufficient and that the country needed a coordinated government-wide effort.
The latest estimates indicate that about one in every 60 adults in Fiji is now living with HIV, compared with roughly one in 167 five years ago. UNAIDS estimates that around 9,100 people were living with HIV in Fiji in 2025, while only 39% were aware of their HIV status and approximately 22% were receiving antiretroviral treatment.
Official surveillance recorded 2,016 newly registered HIV cases in 2025, the highest annual number since Fiji began its HIV surveillance system. The Health Ministry’s statistics report notes that more than 92,000 HIV screening tests were conducted during the year, meaning expanded testing has helped identify people who previously did not know they were infected.
At the same time, the scale of the increase has raised serious concern. UNAIDS estimates that new HIV infections in Fiji increased about 12-fold between 2010 and 2025, placing the country among those experiencing the sharpest recent increases globally. Reuters reported that the number of new diagnoses in 2025 was 27% higher than the previous year.
The epidemic is also affecting children and pregnant women. Fiji recorded 59 babies born with HIV in 2025, while 18 died before reaching their first birthday, according to figures reported by the government. The estimated prevalence among pregnant women has reached about one in 50.
Transmission patterns point to several interconnected challenges. UNAIDS says that among cases where the mode of transmission was known, more than half were associated with sexual transmission and more than 42% with injecting drug use. Fiji’s national surveillance report separately recorded 362 newly diagnosed cases associated with people who inject drugs, although a large proportion of cases still had an unknown transmission route.
Growing methamphetamine use and the sharing of injecting equipment have emerged as major concerns. Health authorities are therefore preparing to introduce a needle-and-syringe programme while expanding access to HIV prevention medicines, including pre-exposure prophylaxis, or PrEP.
The government is also expanding free and confidential HIV testing and treatment and strengthening follow-up care so that people diagnosed with HIV remain connected to medical services. A five-minister Cabinet subcommittee has been established to address policy and implementation barriers and accelerate the national response.
Fiji’s Health Ministry has stressed that the emergency response is not intended to stigmatize people living with HIV. Officials are calling for greater protection of privacy and rights, while community organizations, faith groups and peer outreach workers are being brought into prevention, testing and treatment efforts.
UNAIDS has welcomed Fiji’s decision, describing the situation as a reminder that HIV remains an active global public-health challenge. The agency says Fiji still has an opportunity to change the trajectory of the epidemic through stronger prevention, early diagnosis, treatment access, community participation and sustained cooperation across the Pacific.
