Fiji Declares a National HIV Emergency — and the World Must Pay Attention

Fiji has declared a national HIV emergency after a dramatic rise in diagnoses: 2,016 people learned they were living with HIV in 2025, around 16 times the number recorded in 2019. The Pacific island nation is now expanding free testing, HIV prevention, harm-reduction services and treatment. For LGBTQIA+ people everywhere, Fiji’s situation is a sharp reminder that ending HIV requires more than medicine: it also demands access, anti-stigma work, queer-inclusive healthcare and international solidarity.

Picture : © WHO / Deanna Gerlach
Local children pass by a stream as they head toward Biausevu Waterfall

An epidemic that can no longer be ignored

Fiji’s government has officially declared HIV a national emergency, describing a crisis that requires an urgent, coordinated response across government and society. Health Minister Dr Ratu Atonio Lalabalavu said the declaration recognises both the severity of the epidemic and the need to move beyond “business as usual.”

The figures are stark. In 2025, Fiji recorded 2,016 new HIV diagnoses, compared with roughly 120 in 2019. That is a sixteen-fold increase over six years, and a 27% rise from the 1,583 diagnoses reported in 2024. Officials estimate that one in 60 adults in Fiji is now living with HIV, compared with one in 167 adults five years earlier.

Fiji is an archipelago of more than 300 islands with a population of just over 900,000 people. Its relatively young population — with around one-third aged 15 to 35 — makes the speed of the increase all the more urgent, particularly where prevention, sexual-health information and care services have not reached everyone who needs them.globalnation.

Testing reveals a crisis — and opens a route to care

The number of reported diagnoses must be read with care. An increase can partly reflect expanded testing, which identifies people who were already living with HIV but did not know their status. Fiji’s health authorities have said that their outreach is reaching more people and finding previously undiagnosed cases.

But increased testing does not make the underlying emergency less real. UNAIDS estimates that around 9,000 people were living with HIV in Fiji in 2025, while only 39% knew their status and just 22% were receiving antiretroviral treatment. Those gaps leave people more vulnerable to illness and allow preventable onward transmission to continue.

The government’s response includes more free rapid HIV tests, which can provide a result on the spot; free treatment for people diagnosed with HIV; prevention medication such as PrEP for people at substantial risk of acquiring HIV; and harm-reduction measures for people who inject drugs. The World Health Organization has welcomed the commitment and is supporting Fiji’s response.

HIV is about health, not blame

The emergency is unfolding in a context shaped by both sexual transmission and injecting drug use. Among cases where the mode of transmission is known, more than half are linked to sexual transmission and more than 42% to injecting drug use, according to UNAIDS.

Fiji’s location on trafficking routes serving the much larger Australian and New Zealand drug markets has contributed to concerns about a growing methamphetamine problem. In response, Fiji plans to scale up harm reduction, including a needle-and-syringe programme intended to reduce transmission through shared injecting equipment.

This is where public-health language matters. HIV does not spread because certain people are “irresponsible” or because communities fail morally. It spreads more easily when people are denied practical tools: condoms, PrEP, sterile injecting equipment, accurate health information, confidential testing, non-judgmental care and treatment they can afford and access.

Stigma makes every part of the response harder. It can stop someone from getting tested, make disclosure feel unsafe, and drive people away from health services. A successful HIV strategy must therefore reach people with care rather than punishment — including LGBTQIA+ people, sex workers, young people, people who use drugs, migrants and anyone facing discrimination in healthcare.

The cost of gaps in prevention

The impact on pregnant people and children exposes another painful side of the crisis. Fiji says that around two in every 100 pregnant women are living with HIV. In 2025, 59 babies were born with HIV, and 18 of those children died before reaching their first birthday.globalnation.

With timely testing during pregnancy and effective antiretroviral treatment, HIV transmission during pregnancy, birth and breastfeeding can be dramatically reduced. These outcomes are not inevitable; they point to urgent gaps in testing, continuity of care, treatment coverage and support for families.

The government has warned that, without swift action, the number of people living with HIV in Fiji could reach 25,000 by 2029. That projection underlines why this declaration needs to lead to durable funding and services — not just a moment of international attention.

What queer solidarity looks like

For LGBTQIA+ communities, HIV has always been both global and deeply local. It is shaped by laws, public-health budgets, racism, poverty, gender inequality, access to medication and whether people can seek care safely. The lessons from Fiji should not be framed as a distant crisis affecting “other people”; they are a call to protect universal access to HIV prevention and treatment everywhere.

A queer-affirming HIV response treats people living with HIV as full participants in society, not as risks to be managed. It makes room for pleasure alongside prevention, insists that treatment is healthcare rather than a privilege, and recognises the expertise of affected communities.

It also means remembering a basic truth: people living with HIV who are on effective treatment and have an undetectable viral load do not sexually transmit the virus — often summarised as U=U, or Undetectable = Untransmittable. Fiji’s emergency makes access to that treatment, and to dignified long-term care, all the more essential.

Fiji still has a chance to change the direction of the epidemic. But that depends on sustained action: community-led prevention, treatment without barriers, harm reduction, sexual-health education and support from regional and international partners including Australia, New Zealand, India, the Global Fund, the United Nations and WHO.