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.
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.”