Finally, someone is pointing out something many of us have not thought deeply about. We have got to change our mindset when it comes to effectively dealing with the big HIV challenge.
That is the way to go. We will languish in no man’s land if we are complacent and do not make tough decisions. It may not be straightforward. However, given our predicament, it is arguably a strong path forward.
We cannot tackle the HIV epidemic with yesterday’s interventions. That is the message from Health and Medical Services Assistant Minister Penioni Ravunawa.
Mr Ravunawa says our rapidly escalating HIV epidemic demands a change in how we approach prevention, testing and treatment.
He says yesterday’s interventions alone cannot confront today’s epidemic.
Fiji recorded 2016 new HIV diagnoses in 2025, compared with 245 in 2022.
On top of that, prison HIV cases have risen to 206, up from 173 last year. The Fiji Corrections Service confirmed three inmates had died from AIDS-related complications over the past four years, including two deaths in 2025 and one in 2023.
The service says the current figure represents a 9.3 per cent prevalence rate, compared with 7.8 per cent in 2025 and 6.7 per cent in 2024.
In the face of that, Mr Ravunawa believes our response must be practical, evidence-based and courageous.
Combination prevention, he says, is needed, including condoms, regular testing, early treatment, PrEP, harm reduction, public education and stronger community engagement.
With that in mind, Ministry of Health clinician Dr Dashika Balak believes Fiji must revive its needle and syringe program to fight the HIV epidemic. Speaking during the 2026 Pacific HIV Symposium at the Sheraton Fiji Golf Resort, Nadi, she said unsafe drug injection had become a central driver of infection across the country. It is now central to transmission.
She says people who inject drugs have emerged as an entirely new key population, with 43 per cent of people starting antiretroviral therapy now injecting drugs. That is pretty serious.
It cuts right through many divides. We can talk about the pros and cons of the needle program, but given the scenarios before us, something needs to be done urgently.
Dr Balak presented findings from the first molecular HIV surveillance conducted during Fiji’s outbreak, revealing a 30-fold increase in new diagnoses since 2010.
She said the research identified large transmission clusters linked to shared needles, with infections bridging into sexual partners and the broader community. Now the ball is in our court.
The numbers are not going down. Studies show us what is drastically wrong, and nothing can hide the glaring challenges before us.
The key now is whether we are prepared to make those tough decisions. Like now!
