DIABETES has become the greatest silent threat facing the country.
While HIV/AIDS has garnered significant global and national attention – as it rightfully should – the undeniable fact is that diabetes is deadlier than HIV.
Diabetes Fiji CEO Kini Marawa says diabetes is killing people silently, progressively and indiscriminately.
“It is claiming more Fijian lives today than many other preventable diseases combined,” Mr Marawa said.
“This is not a scare tactic, this is a wake-up call.”
Diabetes vs HIV: Which came first?
Diabetes existed in Fiji long before the first known case of HIV was reported in 1989.
Mr Marawa said for decades, diabetes had been a looming health crisis – deeply affecting communities, families and the economy.
“And yet, unlike HIV, diabetes has been under-prioritised in policy, under-resourced in the health system, and tragically misunderstood by many.
“While HIV treatment and care have seen a robust and well-co-ordinated response – with significant international support and government prioritisation – diabetes has remained neglected.”
He said the time had come to set our priorities right.
The harsh truth: Diabetes as a silent killer
Diabetes is a non-communicable, lifelong disease that quietly destroys the human body.
It damages blood vessels, nerves, organs and immune response. It leads to kidney failure, blindness, heart attacks, strokes and amputations – conditions that devastate lives and drain national resources.
Mr Marawa said in Fiji more than one in three amputations was because of diabetes.
“Fiji records approximately 1200 amputations every year, a figure that continues to rise.
“Thousands are undiagnosed and living with silent complications.”
He said many people died without ever knowing they had diabetes.
“Unlike HIV, which is now largely manageable with medication and care, diabetes often goes unnoticed until it’s too late. That is what makes it deadlier.”
Government inaction and the need for proactive strategies
Mr Marawa said despite clear evidence, diabetes continued to be sidelined.
“Government responses – both past and present – have been fragmented, reactive, and largely dependent on NGOs like Diabetes Fiji Inc., that are working tirelessly to fill the gaps.
“There is no national diabetes registry, limited public education, inconsistent supplies of essential medications, and a growing shortage of trained professionals for diabetes foot care and complications.
“Our hospitals are overwhelmed with avoidable complications, and yet we still focus our investments on tertiary care, instead of primary health care and public health infrastructure, where prevention and early intervention occur.
“We are investing in ambulances to bring the dying to hospital, when we should be building the systems to keep them alive in the first place.”
A call to the Government, development partners and leaders
Mr Marawa is urgently calling on heads of government, political leaders, policy makers, development partners, NGOs, faith-based institutions and local and international stakeholders to set our national health priorities right.
“It is time we see diabetes not just as a medical condition, but as a national crisis that requires political commitment, strategic investment, and multisectoral collaboration.
“We have vast resources and brilliant minds in Fiji, yet our health systems are operating with outdated data, non-standard equipment, and a disconnected approach to non-communicable diseases.
“The pilot for a National Diabetes Registration Project faced delays, lack of digital infrastructure, and no consistent data collection support.
“How do we plan, if we don’t know what we are facing?”
Urgent need for accurate health data and local research
Mr Marawa said one of the greatest challenges in addressing diabetes in Fiji was the lack of reliable and real-time data.
“Our Health Information Unit continues to face underreporting and limited interoperability between systems.
“This creates significant barriers to planning, funding, service delivery, and evaluation.
“Without data, we are flying blind.”
Mr Marawa emphasises that data is the heartbeat of healthcare.
“Without it, there is no clear understanding of the burden, no accurate tracking of progress, no accountability for outcomes and no direction for resource allocation.”
Diabetes Fiji is urging the Government to invest in building an integrated, transparent, and digital health information system that can provide real-time monitoring of the illness and other NCDs.
“Furthermore, we must build local research capacity.
“International researchers often conduct studies here in Fiji and leave without real benefit to our communities or systems.
“This must change. Let’s empower our tertiary institutions, public health researchers, and local communities to lead the research that reflects our reality – not someone else’s hypothesis.”
A national strategy with purpose and priority
Mr Marawa said what is need is not just a plan, but a priority-focused national diabetes strategy – one that includes:
• A fully-funded National Diabetes Registry.
• Investment in Primary Health Care: Community-based screening, education, prevention, and early intervention.
• Nationwide foot care and wound care services.
• Standardised diabetes medical supplies and equipment across all health centres.
• Health information and digital data systems that work.
• Capacity building for nurses, dietitians, physiotherapists, and doctors.
• Youth-focused programs and school interventions.
• Sustainable and reliable medication supply chains.
• Mental health and psychosocial support integration.
• Local research development and implementation.
The role of Diabetes Fiji Inc.
Mr Marawa said Diabetes Fiji Inc. remained at the frontline, working in the most vulnerable communities, identifying undiagnosed diabetics, empowering peer support groups, training frontline health workers, and lobbying for improved services and policy change.
“But we cannot do it alone.
“Our work has included:
• Establishing diabetes peer support groups across the country.
• Launching Young Diabetes Fiji to support and mentor youth.
• Coordinating foot care programs, wound care training, and screening.
• Working closely with the Ministry of Health and global partners.
• Advocating for system-wide reforms in diabetes care.
“But to succeed, we need stronger government leadership, stable funding, and unified national action.”
Mr Marawa said there is a need to stop treating diabetes as an afterthought and begin seeing it as the national emergency that it is.
“The longer we wait, the higher the cost – in limbs, lives, and livelihoods.
“Let this be the turning point. Let us rise together. Let us change the narrative on diabetes in Fiji.
“We have talked long enough, now, let us act.
“Diabetes cannot wait.”
