Fiji’s HIV outbreak is a public health emergency. Pacific neighbours must step up

An alarming HIV outbreak is raging in Fiji, declared a public health emergency by Pacific neighbours. With an HIV prevalence of 1.6% among adults, meaning one in every 60 individuals is living with the virus, the situation is dire. Only a third of those infected know their status, and only a quarter receive treatment. Experts predict that yearly new cases will triple by 2030, with one child born with HIV every week.

The crisis stems from a combination of factors, including rising methamphetamine use and needle sharing, disrupted funding for prevention and treatment services, health system pressures, and a culture of silence and stigma surrounding HIV. In response, Fiji has formed a dedicated HIV response task force and expanded testing and treatment.

PrEP (pre-exposure prophylaxis) is now available, and Fiji is in line for the long-acting HIV prevention drug Lenacapavir. International partners are also providing financial, technical, and on-the-ground support.

The risk extends beyond Fiji's borders, as many New Zealanders, Australians, and Pacific Islanders travel to Fiji for tourism, work, study, and family connections. Fiji serves as a major regional hub, connecting communities throughout the wider Pacific. While travellers should not be alarmed, they should adopt cautious measures such as condom use, accessing HIV prevention tools, and regular testing.

Public health challenges in the Pacific, like HIV, require a regional response due to their interconnected nature. Fiji is seeking support, funding, and technical assistance to overcome this urgent challenge, emphasizing the need for culturally safe services that respect Pacific communities and values.