Fiji has declared HIV a national emergency after a sharp rise in infections placed growing pressure on its health system, with the government moving to expand testing, treatment and prevention services across the Pacific island nation.
Health Minister Antonio Lalabalavu said Fiji recorded 2,016 new HIV diagnoses in 2025, while the number of people living with the virus has continued to climb. About one in every 60 adults in the country is now living with HIV, compared with one in 167 five years ago.
Lalabalavu said the scale of the increase meant the country needed to move beyond its existing response.
“an outbreak-level response is no longer sufficient”.
Fiji, which has a population of less than one million people, is also facing a rise in the number of babies dying from complications linked to HIV, adding to concerns over the impact of the epidemic on families and health services.
Health experts and non-governmental organisations have linked the growing number of infections to several factors, including drug use, unsafe sex, needle sharing and a practice known as “bluetoothing” or “hotspotting”.
The practice involves people who inject drugs using the blood of individuals who are already intoxicated. Health experts say it has contributed to the spread of HIV in parts of Africa and the Pacific.
The practice can also make drug use cheaper because several people can contribute money towards one dose and share it. In Fiji, the limited availability of syringes and needles has also made the practice more common.
As part of its emergency response, the Fijian government plans to introduce a syringe and needle programme aimed at reducing the risks associated with injecting drugs.
Lalabalavu said the country already had enough syringes and needles to support the programme, but changes to legislation would be required before it could be introduced. The necessary amendments are expected to be presented to Parliament.
The minister has also called on Fijians to seek HIV testing, while urging the public to avoid discrimination against people living with the virus.
“No one should be ashamed, threatened, or excluded because of their HIV status,” he said. “Stigma drives people away from the very services that can help them.”
Figures from the Joint United Nations Programme on HIV and Aids (UNAIDS) show that Fiji had about 9,100 people living with HIV in 2025. However, only 39% of them knew their HIV status, while just 22% were receiving antiretroviral treatment.
The treatment rate is well below the global average, where 78% of people living with HIV are accessing treatment.
The worsening epidemic has also increased pressure on Fiji's already stretched health services.
Jason Mitchell, who heads the country's national HIV response taskforce, said it could take more than five years for Fiji to bring the epidemic under control.
“It's a long-term programme, it's not something like Covid that's turned around in two years. HIV is very different,” he told ABC News is an interview.
Mitchell said the growing number of HIV patients was placing additional demands on hospitals and outpatient services, particularly at a time when the wider health system was already struggling.
“For a health system that's already struggling, to have people who should really be well because there's treatment available taking up beds in hospitals and sitting in outpatient... Our clinical services has really been under a lot of pressure.”
He said Fiji would need a sustained response rather than a short-term intervention to deal with the rising number of infections.
UNAIDS has welcomed Fiji's decision to declare a national emergency, saying the move shows the urgency needed to increase action across government and communities.
“It is also a stark reminder to the world that Aids is not over. HIV epidemics can change quickly, and countries need health and community systems that are ready to respond urgently,” said the executive director of UNAIDS Winnie Byanyima.