Health Minister Ratu Atonio Lalabalavu formally announced the emergency on Sept. 15 after the Cabinet endorsed the measure. The declaration moves the government’s response into a higher level of coordination as officials expand HIV testing, treatment and prevention services.

The scale of the increase has changed the character of Fiji’s HIV response. The country had previously declared an HIV outbreak in early 2025, but the number of reported infections has continued to rise. The World Health Organization has described Fiji as experiencing a rapidly escalating epidemic.

New diagnoses have risen sharply

Fiji recorded 2,016 new HIV diagnoses in 2025, compared with about 120 in 2019, according to figures reported by Fiji’s Ministry of Health. That represents a more than sixteen-fold increase over six years.

The government estimates that about one in 60 adults in Fiji is now living with HIV, although the precise number of infections remains subject to uncertainty because not everyone living with the virus has been diagnosed.

The increase has also become visible among pregnant women. Health authorities estimate that about 2% of women receiving antenatal care are living with HIV, meaning transmission is increasingly affecting families and raising concerns about preventing infections from mothers to their children.

In 2025, 59 children were reportedly born with HIV, compared with 32 the previous year. Fiji Sun reported that 18 of those children died before their first birthday.

Unsafe injecting practices are a major concern

Health authorities and international public-health agencies have identified injecting drug use as an important driver of the outbreak.

The WHO reported that 48% of people starting HIV treatment in Fiji in 2024 were people who inject drugs, highlighting the disproportionate effect of unsafe injecting practices on new infections. The agency has also identified gaps in access to prevention and stigma-free healthcare as urgent concerns.

The government plans to expand access to HIV testing and treatment while introducing additional prevention measures, including pre-exposure prophylaxis, or PrEP.

Officials are also preparing to accelerate a formal needle-and-syringe program and expand access to long-acting injectable prevention.

The measures reflect an effort to address transmission before infections become established, rather than relying primarily on treatment after diagnosis.

Mothers and children face growing risks

The increase in infections among pregnant women has added urgency to the response.

HIV can be transmitted from a mother to her child during pregnancy, childbirth or breastfeeding, but treatment can substantially reduce that risk. Early diagnosis is therefore important both for the health of the mother and for preventing transmission to infants.

The number of children born with HIV in Fiji nearly doubled between 2024 and 2025, according to figures reported by Fiji Sun.

The figures also illustrate the consequences of gaps in testing and treatment access. Fiji’s health authorities have warned that without stronger intervention, the number of people living with HIV could reach 25,000 by 2029.

That projection is an estimate rather than a confirmed future total and depends on how the epidemic and national response develop.

Government expands emergency response

The national emergency is intended to accelerate the government’s response across testing, treatment, prevention and community services.

Fiji’s Sexual and Reproductive Health and HIV Programme Management Unit is coordinating implementation with health services and community partners. Australia, New Zealand, the Global Fund, India and UNAIDS are among the international partners supporting the response.

The government is also considering a standing parliamentary committee focused on HIV and related issues, according to reporting on the emergency declaration.

Fiji’s Health Ministry maintains an HIV surveillance program and publishes national data on diagnoses and trends.

Treatment remains central to the response

The emergency declaration is not limited to preventing new infections.

People living with HIV can control the virus with antiretroviral treatment, allowing them to live longer and healthier lives. Effective treatment can also prevent sexual transmission when a person maintains an undetectable viral load.

That makes testing and sustained access to treatment important components of Fiji’s emergency response, alongside prevention programs aimed at people at higher risk of acquiring HIV.

The WHO has emphasized the need for evidence-based harm-reduction measures as Fiji responds to the outbreak.

A growing public-health challenge

Fiji’s emergency declaration comes after several years of rapidly increasing HIV diagnoses and follows the government’s earlier declaration of a national outbreak.

The immediate challenge is expanding prevention and treatment quickly enough to reduce new infections while reaching people who may have HIV but do not yet know their status.

The country’s experience is also attracting attention across the Pacific. Public-health researchers in New Zealand have warned that Fiji’s epidemic could have implications beyond its borders, particularly as countries in the region consider how to strengthen HIV prevention and treatment systems.

For Fiji, the next phase of the response will depend on whether expanded testing, treatment, harm reduction and prevention programs can slow transmission and reach communities currently underserved by the health system.

The emergency declaration marks an escalation in the government’s response. It does not, by itself, determine how quickly the epidemic will be brought under control.

Reporting Credit: Fiji Ministry of Health and Medical Services — national HIV surveillance and government response; World Health Organization — HIV epidemiology, treatment and harm-reduction evidence; Fiji Cabinet and Ministry of Health — national emergency declaration and response measures; UNAIDS and international health partners — regional HIV response support.

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Australian Prime Minister Anthony Albanese and Fijian Prime Minister Sitiveni Rabuka signed the Ocean of Peace Alliance in Fiji’s capital, Suva, alongside a separate economic agreement known as the Vuvale Union. Under the economic treaty, Australia will invest more than 1 billion Australian dollars (about $693 million) in Fiji over the next decade.

The agreements represent Fiji’s first mutual defense treaty and Australia’s fourth such pact, following longstanding defense arrangements with the United States and New Zealand under the 1951 ANZUS Treaty and a bilateral agreement with Papua New Guinea signed last year.

“The Ocean of Peace Alliance introduces a mutual defense obligation and there’s no higher obligation than to come to each other’s aid at a time of need,” Albanese told reporters.

Leaders Say Pact Is Not Directed at China

Rabuka said he did not expect the agreements to damage either country’s relationship with Beijing.

“I do not expect China to have any severe pushback on either government. And I believe that they will welcome the understanding that is between Australia and Fiji,” Rabuka said.

“It does not threaten Fiji’s relationship with China nor Australia’s relationship with China,” he added.

The signing comes as Australia seeks to reinforce its role as the preferred security partner for Pacific island nations following China’s expanding diplomatic and security engagement across the region.

Chinese Missile Test Draws Australian Criticism

The defense pact was announced on the same day Chinese state media reported that China had conducted a test launch of a long-range ballistic missile in the South Pacific.

According to the Xinhua News Agency, the missile carried a dummy warhead and was launched as part of routine military training. China previously conducted a similar intercontinental ballistic missile test in the Pacific two years ago.

Australian Foreign Minister Penny Wong said Beijing had notified Australia in advance of the launch but described the activity as destabilizing.

“I’ll leave China to speak to its intent,” Wong told reporters.

She said Australia had made clear to Beijing that the planned missile test occurred against the backdrop of China’s rapid military expansion, which lacked the level of transparency and reassurance expected by countries across the region.

In Beijing, Chinese Foreign Ministry spokesperson Mao Ning described the launch as a routine military exercise that was not directed at any specific country.

“We hope that the relevant countries will avoid overinterpretation,” Mao said.

Responding to questions about the Australia-Fiji defense agreement, Mao said China’s cooperation with Pacific island nations is based on mutual respect and equality and is not intended to advance political self-interest.

She also urged other countries to respect the independence of Pacific island nations and avoid actions that could harm the interests of third parties.

Australia Expands Pacific Security Partnerships

The agreement with Fiji forms part of a broader Australian effort to deepen security and economic ties across the Pacific.

Canberra accelerated its regional engagement after China signed a security agreement with the Solomon Islands in 2022, raising concerns in Australia and its allies that Beijing could eventually establish a naval base in the South Pacific.

Albanese is scheduled to travel to the Solomon Islands on Tuesday for talks with Prime Minister Matthew Wale after both governments agreed to continue discussions on a possible security arrangement.

Wale said during a visit to Australia last month that his government would review the existing security agreement with China.

On Wednesday, Albanese will host Papua New Guinea Prime Minister James Marape and Tongan Prime Minister Fatafehi Fakafānua in Brisbane.

Australia’s defense treaty with Papua New Guinea is due to formally enter into force on Wednesday.

Last week, Australia and Vanuatu also signed the long-awaited Nakamal Agreement, covering security and economic cooperation. The agreement followed months of negotiations after Vanuatu rejected an earlier draft over concerns it could limit the country’s ability to attract infrastructure investment.

China said last week it was concerned the Nakamal Agreement could be aimed at Beijing.

The latest agreements underscore Australia’s continued push to strengthen partnerships with Pacific island nations as regional governments seek to balance economic development, national sovereignty and strategic competition among major powers.

This report is based on reporting by The Associated Press.

Topics: Australia | Fiji | Pacific Security | China | Defense Alliance | Indo-Pacific | Diplomacy | Regional Security

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