Assistant Minister for Health Penioni Ravunawa’s warning about the rise in HIV cases, particularly among people who inject drugs, is more than a health alert.
It is, as he put it at last week’s Needle and Syringe Programs (NSPs) workshop in Suva, a development, social, and moral challenge that touches every layer of our society.
By describing the growing number of infections as a national security concern that threatens Fiji’s future, he signalled the gravity of what we are facing.
We agree that it is a major concern. We agree that it demands our attention. And we agree that it calls for urgent, coordinated action.
Mr Ravunawa is right to emphasise that the most vulnerable among us, our young people, women, people living with HIV, and those struggling with substance dependence, must not be left behind. Their wellbeing reflects our collective humanity and our nation’s maturity. Protecting them is a measure of who we are and what we are willing to stand for.
Central to this protection, he insists, are needle and syringe programs. “Global scientific data and decades of research show that NSPs work. They reduce infections, they are cost-effective, they protect families and communities, and they save lives.” These programs are public-health tools that form a key pillar of Fiji’s National HIV Strategy, alongside peer education, PrEP, PEP, condom distribution, and accessible testing and treatment.
Yet there may be sceptics who will have reservations that inevitably will arise, worrying that providing sterile injecting equipment could be misinterpreted as encouraging drug use. But NSPs are supposed to prevent infections, reduce long-term treatment costs, and create pathways for people who inject drugs to access health services they would otherwise avoid.
That is why Mr Ravunawa’s warning is so pointed. “If we delay the program, we will see more infections. If we hold back, we will see more preventable deaths among Fijians. If we allow stigma to rule, we will lose more of our people.”
The biggest obstacles, he says, are not technical but attitudinal. “Stigma, discrimination, fear, silence and judgement, these are the real drivers of this outbreak. Stigma kills, discrimination isolates, judgement pushes people further away from care.” His call is for compassion over prejudice, for evidence over fear.
These concerns are echoed by UNAIDS adviser to the Pacific, Renata Ram, who warned that Fiji cannot end HIV transmission without strong harm-reduction services. She described the recent workshop on NSPs as “a major step forward” for the country’s HIV response, citing international evidence from Australia, New Zealand, Portugal, and the United Kingdom, countries that have proven how such programs save lives, prevent outbreaks, and strengthen health systems over time.
But even as Fiji moves to strengthen harm-reduction services, another angle must be confronted: prevention. It is encouraging that national attention is now focused on stopping the spread of HIV, but we must also prevent the next wave of infections before they emerge. That requires robust, honest, and sustained awareness at schools, in communities, and in homes. It requires us to talk openly about HIV, to understand the risks posed by illicit drug use, and to recognise the dangers of behaviours such as needle sharing.
Connecting these two imperatives, harm reduction and prevention, can form the backbone of a successful national response. NSPs are designed to keep people alive and connected to care, reducing the immediate danger. Well, that’s the whole idea really! Education, awareness, and social support reduce the long-term risk by ensuring fewer people are exposed in the first place. Together, they can build resilience not only in individuals but across the nation.
Fiji now stands at a crossroads. We can allow stigma, silence, and denial to deepen the crisis, or we can confront reality with compassion, science, and courage.
