Fiji declares a national HIV emergency as adult prevalence hits 1 in 60

Fiji's health minister, Dr Ratu Atonio Lalabalavu, declared a national health emergency over HIV on 16 September. A Cabinet decision on 9 September had already put the file on a crisis footing. The minister said an outbreak-level response is no longer enough.

The government's figures: one in 60 adults now lives with HIV, against one in 167 five years ago. In 2025 the country recorded 2,016 new diagnoses, 2,060 in one official telling. Five years earlier the caseload was a fraction of that. The New York Times, citing the government statement, said last year's new diagnoses were 16 times the 2019 figure. One in 50 pregnant women is estimated to have the virus. Fifty-nine infants were born with HIV in 2025. Eighteen died before their first birthday.

UNAIDS, in a 16 September statement from Geneva, called the rise one of the sharpest increases in new infections in the world. It estimates 9,100 people were living with HIV in Fiji in 2025. Only 39 percent knew their status. Only 22 percent were on antiretroviral treatment. New infections, the agency said, rose twelve-fold between 2010 and 2025. Executive director Winnie Byanyima called the declaration a reminder that AIDS is not over.

How the virus is moving

Among cases with a known route, more than half were linked to sex and more than 42 percent to injecting drug use. Methamphetamine use has risen in parallel. Fiji declared an HIV outbreak in January 2025 and expanded testing. The minister's point this week is that testing without a wider machine is not catching the curve.

The response now includes a Cabinet subcommittee, wider free voluntary testing, pre-exposure medicine including long-acting injections given twice a year, and a needle-and-syringe programme. Lalabalavu said the country already has the supplies and that parliament will be asked to change the law so the exchange can run. He also said no one should be ashamed, threatened or excluded because of their status, because stigma keeps people away from the clinics that can help them.

A small population, a steep slope

Fiji has fewer than one million people. A 1-in-60 adult prevalence in a country of that size is a health-system event, not a subculture event. Maternity wards, paediatric wards and the antiretroviral supply chain will feel it in the same year. The 18 infant deaths are the number that will be quoted in every donor meeting.

Pacific health services are thin. Fiji is the regional hub for many of them. If the epidemic keeps its present slope, the hub becomes a source. That is why UNAIDS answered within a day and why the minister used the word emergency rather than outbreak. The legal changes on needles, the twice-yearly prevention shots, and the share of the 9,100 who actually start treatment are the three facts to watch next. The declaration is the easy act. Those three are the work.