What’s happening: Fiji declares national HIV emergency

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Fiji's HIV outbreak has become a national public health emergency

Fiji’s Health Minister, Dr Atonio Lalabalavu, declared a national HIV emergency on 15 September 2026. The announcement follows Fiji's declaration of an HIV outbreak in January 2025 and a 27% increase in new diagnoses over the past year. 

The World Health Organisation has previously described Fiji as having the second-fastest-growing HIV epidemic in the Asia Pacific region after Papua New Guinea. Recorded cases increased from approximately 400 in 2014 to 5,900 in 2024.

In January 2025, UNAIDS estimated that around 9,100 people in Fiji were living with HIV. Only 39% were thought to know their status, while 22% were receiving antiretroviral treatment. The estimated number of people living with HIV represents close to 1% of Fiji’s population.

The increase is also affecting maternal and neonatal healthcare. Fiji recorded 59 babies born with HIV in 2025, highlighting gaps in diagnosis, treatment and access to appropriate care.

Traveller risk remains low despite a worsening domestic outbreak

The significant and increasing rates of HIV in Fiji are driven heavily by sexual transmission and growing intravenous drug use throughout the country.

Methamphetamine and cocaine use has increased across Fiji in recent years owing to the country becoming a major trafficking hub for the drug in the past 15 years. Among cases with known transmission routes, approximately 42% of cases are linked to intravenous drug use. 

Syringe scarcity and unsafe injecting practices contribute heavily to this, particularly in Fiji’s capital of Suva, according to reports in 2025. Needle sharing and practices known as ‘bluetoothing’ or ‘hotspotting’, wherein an initial user draws their blood immediately after taking the drug and intravenously administers it to a second person, who may then administer it to a third person and so forth, expose users directly to infected blood. These methods are used because they are cheaper, despite the extreme risks associated with blood sharing and the lack of any barrier to prevent the immediate transmission of blood infections between users. 

Likewise, fear of discrimination when seeking health services is reportedly a major barrier to access to prevention and stigma-free care. Reports indicate that individuals are often deterred from seeking treatment because they fear arrest, discrimination and breaches of confidentiality. Recent initiatives supported by non-governmental organisations (NGOs) and some foreign governments are working to change this. 

The crisis slightly increases exposure risks for travellers visiting Fiji, however these risks can be largely mitigated by taking appropriate precautions and avoiding known risk behaviours. 

Outlook

Prior to the emergency declaration, Fiji endorsed its HIV Surge Strategy 2024-2027 and launched a national HIV Outbreak Response Plan, supported by UNAIDS, the WHO and other partners. 

Since the declaration, Fiji has announced measures to accelerate the country’s HIV response. These measures include expanded HIV prevention, testing and treatment programs, including wider access to preventative medicines like PrEP. Information on PEP accessibility is limited; however, this may change over time.

The government has also announced a formal needle and syringe program intended to allow the legal distribution of clean needles and syringes to improve their accessibility without impacting public health workers, pending regulatory clearance. 

Awareness campaigns and initiatives to reduce stigma and counter misinformation about HIV are also likely to have higher visibility in Fiji in the long term. These are likely to include clearer information on where and how to seek initial testing and treatment, as well as provide information with the purpose of reducing stigma around HIV. 

There is an elevated risk that accelerating these initiatives, and a potential associated increase in reported case numbers due to greater public awareness, may strain Fiji’s already limited healthcare system. Indeed, although blood transfusion in Fiji is centralised and should meet WHO standards, the service is resource-constrained, so supply issues may arise, especially if someone requires a large-volume transfusion or has a rare blood group.  Because resource challenges affect healthcare in Fiji more generally, it is impossible to rule out quality issues that could affect the safety of blood for transfusion. However, support from non-governmental organisations and nations such as New Zealand may help to mitigate these risks. 

What this means for organisations

Travellers are unlikely to be exposed; however, risks increase slightly when receiving medical care in Fiji, so it is advisable to seek dental care and non-emergency treatment elsewhere where possible.

Recommended actions for travellers

• Choose treatment facilities carefully; attend only medical facilities where there is a high degree of confidence in sterilisation procedures and the safety of blood products.
• Consult with family doctors prior to travel to Fiji for pre-trip counselling, to ensure fitness for travel and address potential vulnerabilities.
• Wear closed-toed shoes while out and about to reduce the risk of needle-stick injuries from discarded needles or drug paraphernalia. Consider minimising pedestrian travel during low-light hours and exercise caution when travelling on foot.
• Avoid engaging in behaviours and activities that elevate exposure risks. 

For risk managers: Configure Sentinel to receive ongoing reporting on Fiji’s healthcare environment and related operational developments.

For organisation-specific guidance: Contact the Healix medical and security teams for tailored assessment and support.