Fiji has formally declared HIV a national emergency after one of the sharpest increases in new infections reported anywhere in the world. The declaration was made on September 15, and the World Health Organization said it gives the country an opportunity to intensify prevention, testing and treatment measures that have already been under development for the past two years.
UNAIDS estimates that about 9,100 people were living with HIV in Fiji in 2025, twelve times the number recorded in 2010. Only 39% were estimated to know their status and 22% were accessing treatment. Those figures describe a public-health emergency, but they do not mean that treatment is ineffective. Modern antiretroviral therapy can help people with HIV live long lives and prevents sexual transmission when the virus is suppressed.
What the emergency declaration changes
The declaration can help coordinate government agencies, international partners and community organisations around a single response. WHO says Fiji is expanding free HIV testing and prevention services, including pre-exposure prophylaxis for people at substantial risk of acquiring HIV. The response also includes harm-reduction measures for people who inject drugs and free treatment for people diagnosed with HIV.
Emergency status does not replace routine health services. It should make it easier to reach people who may avoid testing because of cost, stigma, distance or fear of discrimination. Confidentiality and respectful care are therefore essential. If people do not trust clinics or believe a diagnosis will expose them to social harm, they may delay testing even when services are free.
Why prevention and treatment must move together
Testing without treatment leaves people uncertain and allows the virus to continue spreading. Treatment without prevention misses people who do not yet have HIV. Fiji’s response is built around both sides: find infections earlier, connect people to medication, prevent new infections and provide counselling and support.
Needle and syringe programmes can reduce transmission among people who inject drugs when combined with health care and treatment referrals. PrEP can substantially reduce the risk of acquiring HIV when taken as prescribed. These tools work best when services are easy to access and people are not punished or shamed for seeking them. WHO has emphasised that misinformation can deepen stigma and reduce the use of prevention and care.
A regional issue
Fiji is connected to neighbouring Pacific countries through travel, labour, families and health systems. A regional dialogue at a Pacific health meeting highlighted that no country is safe unless countries work together. Sharing surveillance information, testing capacity, medicines and public-health experience can help the region respond before infections become harder to control.
The declaration also shows why national statistics require context. A twelve-fold increase from a low earlier base can reflect a real and severe rise, but it does not mean Fiji has the same number of infections as a much larger country. Public-health planning depends on testing coverage, treatment access, population size and the groups most affected.
What to watch
The key indicators will be whether testing becomes more accessible, whether treatment coverage rises, whether new infections slow and whether people can obtain prevention without discrimination. The government has begun an HIV surge strategy and outbreak response plan, with support from WHO and UNAIDS. Their success will depend on sustained funding, community leadership and regular public reporting.
Fiji’s emergency declaration is serious, but it is not a reason for fatalism. HIV is preventable and treatable. The most effective response is early testing, rapid connection to care, reliable prevention and accurate information that protects people from both the virus and the stigma surrounding it.
That message is especially important for young people and for groups that may face discrimination in health services. Prevention programmes work when people can ask questions privately, obtain condoms or PrEP without judgment and return for follow-up care. Community organisations, peer educators and people living with HIV can help design services that are trusted and culturally appropriate.
Success should be measured publicly but respectfully. Officials can report testing, treatment and prevention coverage without exposing individual patients or creating a map of vulnerable communities. Regular data will help Fiji adjust its response, while protecting confidentiality will encourage more people to come forward. A national emergency should strengthen dignity and access, not weaken them.
