A rapid assessment has revealed that unsafe injecting practices, combined with a lack of harm reduction services, are driving Fiji’s rising HIV epidemic.
UNAIDS estimates suggest that the total number of people living with HIV in Fiji reached 6,100 in 2024, up from around 2,000 in 2020.
The study, commissioned by WHO and UNDP at the request of Fiji’s Ministry of Health and Medical Services (MHMS), found that people who inject drugs frequently reuse needles due to limited access to sterile equipment, putting them at high risk of HIV, hepatitis, and other infections. Methamphetamine was the most commonly injected drug, often exposing users to risk from their very first injection.
Interviews with 56 people who inject drugs and discussions with 50 key informants highlighted low awareness of HIV and barriers to accessing testing and treatment.
Almost half of those starting HIV treatment in 2024 were people who inject drugs, underscoring the disproportionate impact on this group.
The assessment recommends urgently implementing needle and syringe programmes (NSPs) to provide sterile equipment and connect users to essential health services.
Minister for Health, Dr Atonio Lalabalavu, confirmed the government, together with international partners, is fast-tracking NSPs as part of Fiji’s HIV Surge Strategy (2024–2027) and Outbreak Response Plan.
WHO Pacific Director Dr Mark Jacobs said evidence-based interventions like NSPs save lives and prevent infections, while lead researcher Professor Lisa Maher stressed the importance of involving people who inject drugs in outreach and prevention efforts.
UNDP Resident Representative Munkhtuya Altangerel described the epidemic as a pressing health, development, and human rights challenge, urging swift action to reduce new infections and improve access to stigma-free care.
Without urgent intervention, Fiji’s HIV cases are projected to rise further, with serious health and social consequences.
