The Pacific island nation recorded 2,016 new HIV diagnoses in 2025 alone, according to Health Minister Antonio Lalabalavu, who warned that the scale of the outbreak now requires a much broader response.
"An outbreak-level response is no longer sufficient," Lalabalavu said.
About one in 60 adults in Fiji is now estimated to be living with HIV, a substantial increase from approximately one in 167 five years ago. The epidemic is also taking a growing toll on children, with an increasing number of babies dying from complications linked to the virus.
Fiji, which has a population of fewer than one million people, is now confronting an epidemic that is placing additional pressure on an already stretched healthcare system.
Drug Use and Unsafe Practices Fuel Spread
Health experts and non-governmental organisations have identified several factors behind the rapid rise in infections, including drug use, unsafe sex, needle sharing and a practice known locally as "bluetoothing" or "hotspotting".
The practice involves intravenous drug users injecting themselves with blood from someone who has already taken drugs. Health experts say the practice can significantly increase the risk of HIV transmission when contaminated blood is shared.
The practice has also been reported in other parts of the world and has contributed to HIV transmission in some communities.
Cost and limited access to injecting equipment can make the practice particularly attractive to people who use drugs. Multiple users can contribute towards a single dose and share it, while using a single syringe can be easier when clean needles are difficult to obtain.
Fiji's government is now preparing to introduce a national syringe and needle programme as part of its emergency response.
Lalabalavu said the country already has adequate stocks of syringes and needles, with legislative amendments expected to be presented to parliament to allow the programme to be implemented.
Government Urges More People to Get Tested
Increasing access to testing will be another central part of the response.
According to UNAIDS, an estimated 9,100 people in Fiji were living with HIV in 2025, but only 39% knew their HIV status. Just 22% were receiving antiretroviral treatment.
The figures compare sharply with the global situation, where about 78% of people living with HIV are accessing treatment.
Health officials are therefore urging more people to get tested and seek medical care, while also attempting to tackle the stigma that can prevent people from accessing services.
"No one should be ashamed, threatened, or excluded because of their HIV status," Lalabalavu said. "Stigma drives people away from the very services that can help them."
Health System Under Growing Pressure
Jason Mitchell, who leads Fiji's national HIV response taskforce, said reversing the epidemic will require sustained efforts over several years.
He estimated that it could take "upwards of five years for [Fiji] to get on top of the epidemic", stressing that HIV requires a fundamentally different response from a short-term infectious disease emergency.
"It's a long-term programme, it's not something like Covid that's turned around in two years. HIV is very different," he told ABC News.
The growing number of patients is also putting additional pressure on hospitals and other health facilities.
"For a health system that's already struggling, to have people who should really be well because there's treatment available taking up beds in hospitals and sitting in outpatient... Our clinical services has really been under a lot of pressure," Mitchell said.
Modern antiretroviral medicines can suppress HIV and allow people living with the virus to live longer and healthier lives. But the benefits depend heavily on people being diagnosed and having sustained access to treatment.
UNAIDS Welcomes Emergency Declaration
UNAIDS has welcomed Fiji's decision to declare a national emergency, saying the move demonstrates the urgency required to intensify the response across government and society.
The agency said Fiji's situation also carries a wider warning for countries that may assume the global HIV epidemic is under control.
"It is also a stark reminder to the world that Aids is not over. HIV epidemics can change quickly, and countries need health and community systems that are ready to respond urgently," said Winnie Byanyima, executive director of UNAIDS.
For Fiji, the immediate challenge is to bring more people into testing and treatment, reduce the risks associated with drug use and needle sharing, and overcome the stigma surrounding HIV.
The government's emergency declaration signals a shift from containing individual outbreaks to mounting a sustained national response. With thousands of people already living with HIV and new infections continuing to rise, health officials face the difficult task of expanding services quickly while building a longer-term system capable of keeping the epidemic under control.