Fiji is facing a rapidly escalating HIV epidemic, with new cases tripling between 2023 and 2025. This surge, now the world’s fastest-growing HIV outbreak, is driven by a combination of factors: the country’s role as a drug-smuggling hub, rising methamphetamine use, unsafe injecting practices, and systemic failures in healthcare access and awareness. The crisis is particularly devastating for children, with alarming rates of mother-to-child transmission leading to preventable deaths.
The Human Cost: Stories from the Front Lines
The impact of HIV is deeply personal. Clare, a young mother, learned her infant daughter, Andi, tested positive after repeated hospital visits for unexplained illness. Both she and her husband, an injecting drug user, were also found to be HIV-positive. This scenario is becoming tragically common. Across Fiji, families are being torn apart by a disease that remains shrouded in stigma and misinformation.
The situation is dire: one baby a week is diagnosed with HIV through mother-to-child transmission, and one child under five dies each month from HIV-related complications. Dr. Jason Mitchell, head of Fiji’s HIV epidemic response, calls this “inexcusable,” highlighting the preventable nature of these deaths.
Root Causes: Drugs, Stigma, and Systemic Failures
Fiji’s geography and weak border controls make it a transit point for illicit drugs, primarily methamphetamine. This fuels addiction, particularly among young people, who often share contaminated needles due to lack of access to clean supplies. The problem is further compounded by deeply entrenched cultural stigma.
Christopher Lutukivuya, an HIV activist living with the virus since 2013, describes the harsh realities: people with HIV are ostracized, forced into hiding, or driven to suicide rather than face judgment. Traditional beliefs and distrust of Western medicine also hinder prevention efforts, particularly among the Indigenous Fijian population (iTaukei), who make up 90% of new diagnoses.
The Global Context: A Reversal of Progress
This crisis comes as global HIV aid declines, leaving Fiji and other Pacific nations vulnerable. According to the WHO, Fiji is now experiencing conditions reminiscent of the early AIDS epidemics in developed countries – including widespread ignorance about transmission, lack of safe needle programs, and resistance to condom use.
The situation is compounded by a lack of basic knowledge: some Fijians are unaware that HIV can be passed from mothers to babies or that the virus is treatable. Even educated individuals struggle to negotiate safe sex due to power imbalances.
Hope Amidst Despair: Prevention and Treatment Efforts
Despite the bleak outlook, some progress is being made. Doctors and activists are working to combat misinformation and promote treatment as a life-saving option. The Ministry of Health is implementing a safe needle program, and UNAids is pushing for wider access to PrEP (pre-exposure prophylaxis) through tablets, injectables, and vaginal rings.
Initiatives like the Daulomani Safe House, founded by Edwina Biyau, provide support for survivors of drugs, HIV, and violence. Success stories, like Josy Ralulu, a sex worker who now advocates for testing and treatment, demonstrate that living with HIV is not a death sentence.
The Path Forward: Urgent Action Needed
With an estimated 8,900 people living with HIV in Fiji, the crisis is expected to escalate to a generalized epidemic within months. While the Fijian government has invested $10 million in response, alongside aid from Australia and New Zealand, more aggressive intervention is critical.
The key is to break down stigma, increase testing and treatment access, and address the underlying drivers of transmission. This includes strengthening law enforcement to disrupt drug trafficking, improving healthcare infrastructure, and empowering women to negotiate safe sex. The future of Fiji’s most vulnerable populations depends on decisive action now.
