Fiji Declares Formal National HIV Emergency as Infections Surge 12-Fold Over the Past 15 Years, UN Warns

WELLINGTON, New Zealand — Fiji has declared a national HIV emergency after new data showed an estimated one in every 60 people in the South Pacific island nation is living with the virus, prompting the government to significantly expand testing and treatment efforts as officials confront what they describe as a fast-worsening crisis.

According to the Joint United Nations Program on HIV and AIDS, new infections in Fiji have increased twelvefold over the past 15 years. The agency said approximately 9,000 people were living with HIV in the country in 2025, a striking figure for a nation with a population of fewer than one million. UNAIDS data showed that only 39% of those infected knew their HIV status, while just 22% of people living with the virus were receiving antiretroviral treatment, underscoring significant gaps in both diagnosis and care.

The scale of the shift has been particularly stark among specific population groups. Officials said one in every 60 adults in Fiji now has HIV, compared with one in 167 just five years ago. Among pregnant women specifically, the rate is even higher, with one in every 50 estimated to be living with the virus.

Fiji’s Health Minister, Antonio Lalabalavu, announced the elevated emergency designation in a video statement posted to Facebook this week, framing the move as a necessary escalation given the scale of the crisis. “This means HIV is now a national crisis and the government is treating it like one. No more business as usual,” Lalabalavu said. “More people in Fiji are living with HIV than ever before.”

The declaration marks a further escalation from an earlier response. Lalabalavu had designated HIV an “outbreak” in Fiji in January 2025, but said the country’s Cabinet decided this month that classification was no longer a sufficient response to the scale of the problem, prompting the shift to a formal national emergency designation. That elevated status requires government agencies across multiple sectors to coordinate directly with the health ministry in addressing the crisis, rather than treating it as a matter for health authorities alone.

Lalabalavu said part of the apparent rise in case numbers reflects expanded testing efforts reaching more of the population than in previous years, rather than new infections alone. As part of its response, the government said it is expanding access to free HIV testing and free treatment for anyone who tests positive, alongside a needle exchange program aimed at reducing transmission among people who inject drugs. Officials acknowledged, however, that stigma surrounding the illness remains a significant obstacle to getting more people tested and into care. Addressing that concern directly, Lalabalavu said the government’s approach was centered on support rather than punishment. “This is about protecting people — not judging them, not watching them, not shaming them,” he said.

Public health analysts have linked much of the recent surge to the growing use of injected methamphetamine, which has expanded rapidly across the Pacific region as drug trafficking networks increasingly use island nations as transit points for narcotics moving between larger markets. That pattern of rising injection drug use has been identified as a significant driver of new HIV transmissions in Fiji and other Pacific nations grappling with similar trends.

Fiji’s crisis fits within a broader, uneven pattern of HIV prevalence across the Pacific Islands. HIV rates have generally remained low throughout most of the region, with a notable exception in Papua New Guinea, where infections have surged dramatically since 2010, producing the highest and fastest-growing HIV case numbers in the Pacific. Papua New Guinea’s government declared its own national HIV crisis in June 2025, roughly a year before Fiji’s latest escalation.

Public health officials have expressed concern that even nations with historically low HIV prevalence remain vulnerable to sudden outbreaks given the region’s demographic and infrastructure challenges. Most Pacific Island nations have very small populations, and health services in many of these countries are inconsistently funded or unevenly available, conditions that can make it difficult to identify and contain the spread of the virus once transmission begins accelerating.

UNAIDS Executive Director Winnie Byanyima addressed Fiji’s situation directly in a statement, framing the country’s crisis as part of a broader global warning. “A stark reminder to the world that AIDS is not over,” Byanyima said, describing the significance of Fiji’s emergency declaration within the context of ongoing global efforts to control the HIV epidemic decades after it first emerged as a major public health threat.

With Fiji now formally treating HIV as a national emergency, the coming months are likely to bring closer scrutiny of the government’s expanded testing and treatment programs, along with continued monitoring from regional and international health bodies tracking whether the country’s response succeeds in narrowing the substantial gaps in both diagnosis and treatment access that UNAIDS data has identified as central weaknesses in the country’s response to date.