The Fijian government estimates that 1 in 60 adults in the country are now living with HIV, including 1 in 50 pregnant women.
Due to the seriousness of the epidemic, the country has declared a national emergency.
The SMC asked experts to comment.
Associate Professor Akisi Ravono, School of Nursing, University of Fiji, comments:
“The HIV pandemic in Fiji and the recent announcement by the Minister for Health and Medical Services signify the urgency in the much needed response to the issue. It calls for a collective action by the Vanua, Health Ministry, NGOs and other government ministries and agencies to very quickly put together strategies to assist in curbing the spread of HIV.
“Nurses as the largest category of health professionals in Fiji (and international) should play leading roles in engaging communities. Nurse-led teams must be mobilised now to communities to start educational sessions and demonstrate prevention strategies. Test kits should be made available and a helpline especially set up for people living with HIV or those who have tested positive must be available 24 hours.
“Currently, the MOH have identified ‘Red Zones’ for areas that have a lot of cases. This labeling must be removed, as they added to the anxiety and fear of the unknown, about HIV and can be a barrier to health seeking behaviors.”
Conflict of interest statement: “No conflict of interest.”
Dr Radilaite Cammock, Associate Professor – Public Health and Deputy Associate Dean – Pacific Advancement, Auckland University of Technology, comments:
“I think the escalation is absolutely warranted given the announcement that 1 in 60 Fijians are living with HIV. This is staggering and tells us that the disease is permeating every part of society, not just certain groups in the population.
“What this means, is that all Fijians have a part to play in addressing the issue, as the spread will affect every community. Additionally, the escalation calls for a wider, multisector response that addresses the socio-cultural factors at play, especially when it comes to prevention and getting people tested. Critical communication and health promotion strategies that address Fijian’s views on getting tested and what the prospect of getting a positive result might mean, alongside management and treatment is warranted.
“The proposal to establish a parliamentary standing committee on HIV and related matters is encouraging as it signals a commitment to address the issue in parliament, while also creating an avenue for all sectors to come together at that level e.g. education, justice etc.”
Conflict of interest statement: “No conflict of interest to declare.”
Dr Sharon McLennan, Senior Research Fellow, School of Health, Victoria University of Wellington, comments:
“Fiji’s declaration of a National HIV emergency is a stark reminder that increased global and regional connectivity can bring significant public health challenges. Triggered by an increase in drug trafficking and use and pressures on the health system, the Fiji epidemic has the potential to become a significant regional health concern.
“While NZ is unlikely to experience a similar surge in HIV cases, Fiji’s role as a regional transport, education and business hub means the epidemic is relevant to New Zealand’s public health interests. Health agencies have already responded through clinical alerts, professional education and public health messaging, recognising the importance of maintaining New Zealand’s progress in HIV prevention and care.
“NZ has also committed financial and technical assistance to support Fiji’s response, while Australia has recently scaled up its support for Fiji, reflecting the reality that our health security is closely linked to that of our Pacific neighbours.
“These actions represent an important start. Continued investment in prevention, testing and treatment services in Fiji, alongside support for Pacific-led prevention, testing and treatment initiatives in New Zealand will be critical to limiting the longer-term impact of the epidemic.”
Conflict of interest statement: Not yet received.
Dr Jalal Mohammed, Senior Lecturer, Faculty of Health, University of Canterbury and Adjunct Professor, University of Fiji, comments:
“Fiji is facing a once-in-a-generation health crisis. HIV diagnoses in Fiji have risen roughly 3000% since 2010, and 1400% since 2022. While the overall prevalence is 1%, it is 1.6% among 15-49-year-olds. Accounting for undiagnosed cases, this figure will increase (conservatively by 45%).
“The epidemic is now moving into a generalised epidemic phase. This means that it is moving from its concentrated risk group (which in Fiji’s case is intravenous drug users) to the generalised population. We are seeing increased rates of sexual transmission and, sadly, mother-to-child transmission. Fiji’s Ministry of Health has reported that there is one child born every week with the virus (56 in 2025) and one child dies every month from it (16 in 2025).
“If the surge continues, the overall prevalence rate is likely to rise to 4% to 5% by 2031. However, with action, this rate would be between 2% and 3% by 2031.
“Fiji’s Cabinet has now formally declared the outbreak a national emergency under Section 69 of the Public Health Act 1935, last used during the COVID-19 pandemic. It recognises the gravity of the situation and the alarming rates of infection and spread. In coordination with the HIV/AIDS Act 2011, this declaration now strengthens Fiji’s response through whole-of-government and whole-of-society action.
“A five-minister Cabinet Subcommittee has been set up to remove barriers to rapid action. Whole-of-society action calls for coordination and action among the government, faith-based organisations, communities, and the people. This declaration provides the impetus for a scaled-up national response.
“Lessons from countries that have experienced HIV outbreaks of this magnitude, such as Papua New Guinea, reveal that without a nationally coordinated response and infrastructure, it will be challenging to control and reduce the spread of infection and scale up interventions. This is a welcome step, but it requires the resources to support the national strategy, mechanisms, and infrastructure that will allow Fiji to reduce infection rates.”
Conflict of interest statement: “No conflict of interest.”