PACIFIC ALARM: FIJI’S HIV CRISIS SPARKS CALL FOR NEW ZEALAND TO STEP UP

New Zealand is being urged to significantly strengthen its response to Fiji’s rapidly escalating HIV epidemic, with public health researchers warning the crisis can no longer be treated as an issue contained within one Pacific nation.

Dr Sharon McLennan, a public health researcher at Te Herenga Waka Victoria University of Wellington, says the extraordinary growth in HIV infections in Fiji has become a regional health security issue, requiring stronger cooperation between Fiji, New Zealand and other Pacific partners.

Fiji is experiencing one of the fastest-growing HIV epidemics in the world, with researchers estimating adult HIV prevalence has reached about 1.6 percent — roughly one in every 60 adults.

The scale of the increase has been dramatic.

Fiji recorded 2,016 HIV diagnoses during 2025, the highest annual figure in the country’s surveillance history and a 27 percent increase from the 1,583 diagnoses recorded in 2024. Of the 2025 diagnoses, 646 involved people aged between 20 and 24.

A CRISIS GROWING AT EXTRAORDINARY SPEED

UNAIDS estimates fewer than 500 people were living with HIV in Fiji in 2014.

By 2024 that estimate had climbed to around 5,900 people, while only 36 percent of those living with HIV were estimated to know their status and just 24 percent were receiving treatment.

The situation has continued deteriorating.

Researchers say infections have increased around 14-fold over the past five years, while current estimates put HIV prevalence among pregnant women at around 2 percent. The equivalent of approximately one child a week is now being born with HIV in Fiji, while around one child a month is dying from HIV-related illness.

Without effective intervention, projections suggest the situation could become considerably worse.

Fijian health officials warned during the Pacific HIV Symposium last month that the number of people living with HIV could reach approximately 25,000 by 2030 if current interventions prove ineffective.

INJECTING DRUG USE DRIVING TRANSMISSION

One of the major drivers of the epidemic is unsafe injecting drug use.

World Health Organization data shows that among people beginning HIV treatment in Fiji during 2024, 48 percent were people who inject drugs. The rapid spread of methamphetamine use and needle sharing has created an urgent need for harm-reduction programmes alongside conventional HIV prevention.

Fiji declared a national HIV outbreak in January 2025 and has subsequently moved to expand testing, treatment, prevention and harm-reduction measures.

But researchers argue the scale and speed of the epidemic mean Fiji should not be expected to confront it alone.

WHY THIS MATTERS TO AOTEAROA

McLennan says the deep connections between New Zealand and Pacific countries make the epidemic directly relevant to Aotearoa.

Fiji is a major Pacific transport, tourism, education and business hub. Families regularly travel between Fiji and New Zealand, while migration, employment and cultural relationships connect communities across national borders.

Disease does not recognise those borders.

Researchers say New Zealand has already made substantial progress through its National HIV Action Plan and its ambition to eliminate local HIV transmission and AIDS-related deaths by 2030.

But a rapidly expanding epidemic within a closely connected Pacific neighbour creates new challenges for maintaining that progress.

NEW ZEALAND HAS ALREADY PROVIDED MILLIONS

Aotearoa has already contributed to Fiji’s response.

In July 2025, New Zealand committed NZ$4 million towards Fiji’s HIV outbreak response.

The funding was intended to expand community-based testing and treatment, introduce harm-reduction initiatives including needle and syringe programmes, improve access to pre-exposure prophylaxis or PrEP, and strengthen peer-led community support.

McLennan and fellow researchers acknowledge those steps but argue the response now needs to go further.

They want greater investment in Pacific-led engagement and leadership, culturally safe HIV prevention, expanded testing and support services for Pacific communities in New Zealand, and sustained financial and technical assistance for HIV prevention and treatment throughout the region.

They also argue HIV should be addressed across health, foreign policy and international development rather than treated solely as a clinical issue.

STIGMA CAN BE AS DANGEROUS AS THE VIRUS

Any response will also need to confront stigma.

Fear, discrimination and shame surrounding HIV, sexuality and drug use can prevent people from seeking testing or treatment.

That becomes particularly dangerous when large numbers of people living with HIV do not know they have the virus.

Modern antiretroviral treatment means people living with HIV can live long and healthy lives, while effective treatment can suppress the virus to the point where it cannot be sexually transmitted.

Testing, early diagnosis and access to treatment are therefore central to bringing an epidemic under control.

For Pacific communities, researchers argue those services must also be designed with communities rather than simply delivered to them.

A PACIFIC PROBLEM REQUIRES A PACIFIC RESPONSE

The warning from McLennan comes as international HIV programmes face wider funding uncertainty.

UNAIDS warned in July that reductions in international funding and cuts to prevention and community services threaten to reverse decades of global progress against HIV. Around 1.2 million people acquired HIV worldwide during 2025 and approximately 570,000 people died from AIDS-related illnesses.

Against that backdrop, Fiji represents one of the clearest warnings of what can happen when prevention, treatment, drug harm reduction and community health systems fail to keep pace with a rapidly changing epidemic.

For New Zealand, the argument is increasingly that helping Fiji is not simply foreign aid.

It is an investment in the health security of the entire Pacific region — including Aotearoa.

The Pacific is connected by whakapapa, migration, trade, tourism and whānau. Its health challenges are increasingly connected as well.

Fiji’s HIV emergency may be unfolding across the ocean, but researchers are warning that the response needs to begin with a simple recognition: in the Pacific, nobody confronts a public health crisis alone.

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