Fiji has declared a national HIV emergency after a sharp rise in new diagnoses, prompting the government and international partners to expand testing, prevention, treatment and harm-reduction services. The Pacific nation’s health authorities say the response must address both sexual transmission and the growing role of injecting drug use.
The declaration was announced on 16 September 2026 by Fiji’s Health Minister Atonio Lalabalavu. It follows 2,016 new HIV diagnoses recorded in 2025—16 times the number reported in 2019, according to authorities.
Why Fiji has declared a national HIV emergency
Fiji’s estimated HIV prevalence has risen significantly. UNAIDS said the virus now affects approximately one in 60 adults, compared with one in 167 five years earlier.
Among cases where the transmission route was known, more than half were associated with sexual transmission and more than 42% with injecting drug use. Health officials have linked the increase to the emergence of a high-risk network of people who inject drugs, including people working in the sex industry.
The figures have placed additional pressure on Fiji’s public-health system and raised concern about access to early diagnosis, prevention medicine and consistent treatment.
Impact on pregnant women and babies
The crisis is also affecting maternal and newborn health. UNAIDS reported that two in every 100 pregnant women in Fiji carry HIV. In 2025, 59 babies were born with HIV, and 18 died before reaching their first birthday.
HIV can pass from a mother to a baby during pregnancy, labour or delivery, or through breastfeeding. Testing during pregnancy, antiretroviral treatment and appropriate clinical support can reduce the risk of transmission, making early access to care a central part of Fiji’s response.
What measures is Fiji introducing?
The government says it is expanding free services for people at risk of acquiring HIV and for those already living with the virus. The planned response includes:
- Rapid HIV testing and wider access to screening;
- Preventive medication for people at higher risk;
- Harm-reduction measures for people who inject drugs;
- Free treatment for people diagnosed with HIV; and
- Stronger support for prevention during pregnancy and after birth.
UNAIDS also welcomed Fiji’s plan to introduce legislation supporting a needle and syringe programme. Such programmes are designed to reduce the sharing of contaminated injecting equipment while connecting people with testing, treatment and other health services.
International support for Fiji’s response
Fiji is receiving assistance from Australia, New Zealand, India, the Global Fund and the United Nations. The support is intended to help strengthen national health services and accelerate access to prevention and treatment across the country.
UNAIDS Executive Director Winnie Byanyima said Fiji’s declaration recognised the urgency of the situation and highlighted the need for health and community systems capable of responding quickly when transmission patterns change.
UNAIDS regional director Eamonn Murphy described the declaration as a call for action rather than fear. He stressed that HIV is not transmitted through everyday contact and that people receiving effective treatment who have an undetectable viral load do not sexually transmit the virus.
How drug trafficking has contributed to the crisis
Fiji’s location in the Pacific has made it a transit point for drugs moving from Latin America and Asia towards markets in Australia and New Zealand. International crime researchers have reported a rise in the movement of methamphetamine and cocaine since the disruption caused by the COVID-19 pandemic.
Some of those drugs are increasingly entering domestic markets. One factor identified by researchers is the practice of criminal groups paying local facilitators with drugs rather than cash. That can increase local availability and contribute to higher levels of injecting drug use.
The health emergency therefore has a wider public-policy dimension. Fiji’s response will need to combine medical services with drug-use prevention, community outreach, maternal healthcare and measures addressing organised trafficking.
Why the declaration matters beyond Fiji
The announcement is a significant development for public health in the Pacific because it illustrates how quickly an HIV epidemic can change when new transmission networks emerge. It also underlines the importance of reliable surveillance, accessible testing and treatment that people can obtain without stigma or discrimination.
Regional cooperation will be particularly important. Drug-trafficking routes, migration, healthcare access and infectious-disease risks do not stop at national borders. Fiji and its partners are expected to work with other Pacific countries and international agencies to improve prevention and maintain access to medicines.
The declaration does not mean HIV is spread through ordinary social contact. Public-health messaging remains essential to prevent misinformation and encourage people to seek testing and care.
What happens next?
Fiji’s immediate priorities are to expand free testing, improve access to prevention medicine, provide treatment to people living with HIV and establish harm-reduction services for people who inject drugs. The proposed needle and syringe legislation will also require further national action before it can be implemented.
International partners will continue supporting the government, while health officials monitor new diagnoses and transmission patterns. The effectiveness of the response will depend on whether services reach people most at risk and whether pregnant women and newborns receive timely care.
Conclusion
Fiji’s national HIV emergency declaration reflects a rapid and serious increase in transmission, driven mainly by sexual transmission and injecting drug use. The country still has an opportunity to change the course of the epidemic through free testing, effective treatment, prevention during pregnancy, harm reduction and sustained regional cooperation. The central message from health authorities is clear: urgent action is needed, but fear and stigma will not help contain the crisis.
