Context
Fiji declared HIV a national emergency on 15 September 2026 after experiencing one of the fastest-growing HIV epidemics globally.
According to UNAIDS, new HIV infections increased 12-fold between 2010 and 2025. Around 9,100 people were estimated to be living with HIV in 2025, but only 39% knew their status and 22% were receiving antiretroviral treatment (ART).
The emergency therefore reflects both rapid transmission and major gaps in diagnosis and treatment.
What Is Driving Fiji’s HIV Crisis?
Injecting Drug Use
Among cases where the mode of transmission was known, more than 42% were linked to injecting drug use. Sharing contaminated needles allows HIV to enter directly through blood.
The problem is intensified by limited access to harm-reduction services. A WHO-supported assessment found unsafe injecting practices and lack of clean injecting equipment to be major drivers of transmission.
Sexual Transmission
More than half of cases with a known transmission route were associated with sexual transmission, showing the continuing importance of safer-sex practices, testing and preventive medicines.
Diagnosis Gap
With only 39% of people living with HIV aware of their status, many infections remain untreated and transmission can continue unknowingly.
Low Treatment Coverage
Only 22% were accessing ART in 2025. This is a major public-health weakness because treatment serves two functions:
Protecting the patient + Preventing onward transmission
Stigma
Fear of discrimination can discourage testing, disclosure and treatment, allowing infections to remain outside the health system.
Fiji’s Response
Expanded Testing and Treatment
The government plans to widen access to free HIV testing and treatment, improving early diagnosis and viral suppression.
Harm Reduction
Fiji plans to introduce needle and syringe programmes, which WHO recognises as an evidence-based intervention for reducing HIV transmission among people who inject drugs.
Preventive Medicines
Access to pre-exposure prophylaxis (PrEP) is being expanded, including newer long-acting options. PrEP reduces the risk of acquiring HIV among people at substantial risk.
Community-Based Outreach
Community organisations and peer workers are being used to reach populations that may avoid formal health services because of stigma or criminalisation.
Why Does Fiji’s Experience Matter?
Fiji demonstrates that HIV epidemics can re-emerge rapidly even in relatively small populations when prevention, diagnosis and treatment coverage remain inadequate.
The key public-health lesson is:
High-risk transmission + Low testing + Low treatment → Rapid epidemic expansion
Effective HIV control therefore requires an integrated response:
Prevention + Early diagnosis + ART + Harm reduction + Community trust
What Is HIV?
Human Immunodeficiency Virus (HIV) attacks the immune system, particularly CD4 T-cells, weakening the body’s ability to fight infections.
Without treatment, HIV can progress to Acquired Immunodeficiency Syndrome (AIDS), the advanced stage of infection.
Modern antiretroviral therapy can suppress the virus to very low levels, allowing people with HIV to live long and healthy lives. Effective viral suppression also prevents sexual transmission of HIV.
How Is HIV Transmitted?
HIV spreads through specific infected body fluids, mainly through:
- sexual contact;
- contaminated blood;
- sharing needles or syringes;
- mother-to-child transmission during pregnancy, childbirth or breastfeeding.
It is not spread through ordinary social contact such as hugging, shaking hands or sharing everyday spaces.
FAQs
Q1. Why did Fiji declare a national HIV emergency?
Because HIV infections increased sharply while diagnosis and treatment coverage remained very low.
Q2. How many people were estimated to be living with HIV in Fiji in 2025?
Around 9,100.
Q3. What is a major emerging driver of HIV transmission in Fiji?
Unsafe injecting drug use, alongside continued sexual transmission.
Q4. What is the purpose of a needle and syringe programme?
It provides sterile injecting equipment to reduce blood-borne transmission among people who inject drugs.
Q5. Can HIV treatment prevent transmission?
Yes. Effective ART can suppress HIV to undetectable levels, preventing sexual transmission.
