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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