Fiji HIV Epidemic: Rapid Growth & UN Warning – 2025 Data

Fiji is confronting a rapidly escalating HIV epidemic, now considered the fastest-growing in the world. More than 1,200 people were diagnosed with HIV in the first six months of 2025 alone, a stark increase from previous years. This surge is linked to a complex interplay of factors, including the island nation’s role as a transit point for illicit drugs, rising methamphetamine use, unsafe injecting practices and limited access to harm reduction services.

A Dramatic Shift in HIV Prevalence

Just three years ago, Fiji reported 245 new HIV cases. By 2024, that number had jumped by 550 percent to 1,583. This “explosive” increase, as described by Dr. Kesaia Tuidraki, acting country director at Medical Services Pacific, has prompted a scramble to understand and address the crisis. The situation represents a significant departure from decades of relatively minimal HIV spread within the country. The names of individuals impacted by the epidemic, like Mirry, Francine, Andi, Clare, Isac and Nemaia, have been changed to protect their privacy.

The Role of Methamphetamine and Injecting Drug Use

The primary driver of this surge appears to be a boom in methamphetamine use. Fiji has historically served as a transit point for the illicit drug trade in the Pacific. However, pandemic-related disruptions to trade routes led to increased domestic consumption. As Eamonn Murphy, the Asia-Pacific region director of UNAIDS, explained, “Drug supply used to transit through Fiji, it wasn’t really a domestic market. But during Covid, the drug trade got stuck there. That’s when increasing use of injecting drugs met a background epidemic that had been neglected.” The Telegraph details this shift, highlighting how the pandemic inadvertently created conditions for a rapid increase in injecting drug use and, HIV transmission.

Data from 2024 reveals that 48% of individuals starting HIV treatment were people who inject drugs, underscoring the disproportionate impact on this population. This highlights the urgent need for targeted interventions focused on harm reduction. The World Health Organization emphasizes the importance of addressing unsafe injecting practices as a key component of Fiji’s response.

Gaps in Prevention and Care

Beyond the increase in injecting drug use, several other factors are exacerbating the crisis. A joint rapid assessment commissioned by the WHO and UNDP, and funded by The Global Fund, identified significant challenges in accessing prevention services and stigma-free care. The assessment, conducted by the Kirby Institute at the University of New South Wales, Fiji National University, and the Australian Injecting and Illicit Drug Users League, revealed widespread syringe scarcity and fear of discrimination among people who inject drugs in Suva. These barriers prevent individuals from accessing essential harm reduction interventions, such as needle and syringe programs (NSPs).

Low health awareness and cultural stigma surrounding HIV likewise contribute to the problem. These factors can discourage individuals from getting tested, seeking treatment, or disclosing their status, hindering efforts to control the epidemic. UNAIDS has consistently highlighted the need to address stigma and discrimination as crucial steps in the fight against HIV in Fiji, with numerous campaigns and initiatives aimed at raising awareness and promoting acceptance.

Harm Reduction Strategies and National Response

In response to the escalating epidemic, Fiji is taking steps to strengthen its HIV response through evidence-based harm reduction interventions. A two-day national workshop was held in Suva to apply the new WHO Operational guide for needle and syringe programmes for people who inject drugs to the Fijian context. This workshop, convened and funded by the United Nations Population Fund (UNFPA), brought together representatives from the Ministry of Health and Medical Services, WHO, UNAIDS, UNDP, and other partners to develop a comprehensive strategy for implementing NSPs.

Needle and syringe programs are a cornerstone of harm reduction, providing sterile injecting equipment to reduce the risk of HIV and other bloodborne infections. These programs also offer opportunities for education, counseling, and referral to other health services. However, the success of NSPs depends on overcoming barriers to access and addressing the stigma associated with injecting drug use.

What’s Next: Strengthening Surveillance and Expanding Access

The immediate priority is to expand access to harm reduction services, particularly NSPs, in areas with high concentrations of people who inject drugs. This requires addressing logistical challenges, such as ensuring a consistent supply of sterile needles and syringes, and overcoming legal and regulatory barriers. It also necessitates training healthcare workers to provide non-judgmental and culturally sensitive care.

Strengthening HIV surveillance is also crucial for monitoring the epidemic and evaluating the effectiveness of interventions. This includes improving data collection, analysis, and reporting systems, as well as conducting regular surveys to assess HIV prevalence and risk factors. Continued collaboration between the Fijian government, international organizations, and community-based groups will be essential for sustaining the response and achieving long-term control of the epidemic. The Ministry of Health and Medical Services (MHMS) will be central to these efforts, working with partners to implement evidence-based strategies and address the underlying drivers of HIV transmission.