In mid-September 2026, the government of Fiji declared a national emergency in response to a sharp increase in HIV infections. Public health officials, including Dr. Jason Mitchell, chair of the National HIV Outbreak and Cluster Response Taskforce, described the situation as the fastest-growing HIV epidemic in the world. Official reports indicate that HIV cases in the island nation rose 12-fold between 2010 and 2025.
Health experts attribute the surge to a parallel increase in crystal methamphetamine use, particularly among youth. Dr. Sailosi Soqo, a member of the national HIV response team, stated that travel restrictions and increased border security during the COVID-19 pandemic disrupted drug transit routes to Australia and New Zealand. This resulted in narcotics intended for other markets remaining in Fiji, fostering a domestic market for injectable drugs where one had not previously existed.
Specific practices associated with meth use have accelerated transmission, according to medical officials. Dr. Dashika Balak, who leads national HIV treatment efforts, noted a shift from smoking to injecting the drug. A practice known as "bluetoothing" or "hotspotting"—where one person injects the blood of another who has already consumed the drug—has emerged as a cheaper way to get high in settings of extreme poverty. Sharing needles is also common due to a scarcity of sterile equipment. In 2025, sexual intercourse accounted for approximately 50% of new infections, with low reported condom use among those with multiple partners.
The epidemic is now estimated to affect 1 in 60 adults in Fiji. While between 9,100 and 12,000 people are believed to be living with the virus, only 5,676 have been officially diagnosed as of September 2026. In 2025, 59 babies were born with HIV, representing an 18% transmission rate from mother to child, which Mitchell characterized as the highest vertical transmission rate in the world. Approximately two-thirds of all cases involve individuals between the ages of 20 and 34.
The concrete day-to-day impact includes an increasing strain on Fiji’s healthcare infrastructure. Main hospitals are reporting overcrowding and chronic staffing shortages, while primary healthcare facilities and tuberculosis hospitals are seeing a rise in advanced HIV cases. The lack of clean needles—caused in part by law enforcement crackdowns on pharmacies—has forced a reliance on shared equipment, which reports suggest allows one infected person to pass the virus to an average of 10 others. Without a change in the current trajectory, health officials project that 25,000 people will be living with HIV by 2029, a level of infection that Dr. Soqo stated could push the health system to collapse.
International aid has begun to flow into the region to address these needs. In August 2026, the Australian government announced a $48 million funding package to support testing, early diagnosis, and expanded treatment access. Future efforts include the introduction of lenacapavir, an injectable preventive drug administered twice yearly, and vaginal rings for pregnant women. However, domestic policy remains divided; a proposal to distribute sterile needles has been blocked by the director of the prosecution, who has threatened to charge health workers with aiding and abetting drug use if they proceed. Specialized HIV response teams are currently being established in 21 locations to decentralize care.