Fiji’s Health Minister Dr Ratu Antonio Lalabalavu has defended the government’s handling of the country’s HIV crisis.

HIV is surging in Fiji with at least 9000 people — or nearly one percent of the population — reported to be now infected.

There are concerns that the real figure could be significantly higher, with global health experts saying HIV is historically under-reported.

The World Health Organisation (WHO) believes the country has been gripped by an “escalating HIV outbreak”.

The island nation declared an HIV outbreak in January last year, with the government calling it “a national crisis” and regional health experts warning that it could spread across the region.

Dr Lalabalavu told Pacific Waves that despite the rising tide of infection the government’s response to the crisis had been “responsible”.

“Look at the [HIV] trend and how it started, it goes way back to 2017, 2018. We are the government that recognised it and now we are doing something about it.”

Budget allocation
The government allocated FJ$10 million (US$4.4 million) in last year’s Budget towards initiatives designed to tackle the problem, he said.

“From last year there have been government initiatives put in place to ensure that we do try and get this under control.”

“In 2025, Fiji recorded 2003 new diagnoses, up from 1583 in 2024, with the national rate diagnosis rising to 226 per 100,000, up from 13 per 100,000 in 2019 — a 17-fold increase,” he said.

“Men remain more affected, but the gap is narrowing, showing that infection is increasingly affecting women and families.”

On top of that, a new trend has emerged showing that the number of HIV-positive newborns is on the rise, according to the head of Fiji’s National HIV Outbreak and Cluster Response team, Dr Jason Mitchell.

Sixty babies were born with HIV last year, up from 31 cases in 2024 and more than 3 percent of women attending antenatal care in Fiji were testing positive for HIV, with the number slightly higher in the capital, Suva, Dr Mitchell said.

One baby is being diagnosed with HIV every week due to mother-to-child transmission, and one child is dying every month from advanced HIV disease.

Mother-to-child transmission
Mother-to-baby transmission is a growing concern, according to treatment support worker Dashika Balak.

“They (the mothers) test negatively initially but over the course of the pregnancy they acquire HIV,” Balak said.

“This is a new trend that we are seeing, because these women may not have risky behaviours but most of the partners are injecting drug users and in pregnancy people do have sex.”

Testing during pregnancy is now underway to reduce the risk of transmission to babies, she said.

Dr Lalabalavu has admitted that sexual promiscuity and drug use among youth in particular are huge contributing factors in the HIV epidemic.

Asked exactly how the government planned to address this, he said “a behavioural change programme” was needed to ensure that happens.

“It is part of the plan, you need good planning and a programme to ensure that is implemented across the board,” he said.

“It is not just something for the Ministry of Health, it’s for the various ministries, important stakeholders, the vanua, the church and the family in general.”

“We will have to tread carefully in terms of how it is accepted within the community, and also we need to look into the legal aspect of it. So we are in the final stages of ensuring that the programme is endorsed.”

Cultural and religious beliefs played a part in the sensitivity around the issue in Fiji, he said.

“First of all, you need to create awareness that by doing this we are not advocating for drug use. That is the challenge and the narrative that we need the general public are aware of,” he said.

“Right now we are looking at avenues to ensure that we get the message to important stakeholders such as the community, the vanua, and religious-based organisations that are here.”

“We want to tap into their capabilities so they can, together with the ministry, pass this message along to their congregations and to the public at large,” he said.

Echoing this, Mitchell told Fiji’s state broadcaster that introducing the programme would not be easy, given the negative reactions in the past when condom use and family planning were phased in.

He said health officials were accused of promoting promiscuity among youth, when they were responding to public health needs.

However, he stressed that the needle and syringe programme was crucial to reducing HIV and Hepatitis C infections in the country.

Needle sharing is described as widespread in group settings, leading to infection clusters within families and communities.

The Health Minister said he expected that by the time the programme went public, it would be well accepted by the people.

This article is republished under a community partnership agreement with RNZ.

Article by AsiaPacificReport.nz

Fiji’s Minister for Health and Medical Services has declared an HIV outbreak.

Dr Ratu Atonio Rabici Lalabalavu announced 1093 new HIV cases from the period of January to September 2024.

“This declaration reflects the alarming reality that HIV is evolving faster than our current services can cater for,” he said.

“We need the support of every Fijian. Communities, civil society, faith-based organizations, private sector partners, and international allies must join us in raising awareness, reducing stigma, and ensuring everyone affected by HIV receives the care and support they need.”

In early December, the Fiji Medical Association called on the government to declare an HIV outbreak “as a matter of priority”.

As of mid-December, 19 under-fives were diagnosed with HIV in Fiji.

The UN Development Programme has recently delivered 3000 antiretroviral drugs to Fiji to support the HIV response.

World’s largest epidemic
A report released in mid-2024 showed that in 2023, 6.7 million people living with HIV were residing in Asia and the Pacific, making it the world’s largest epidemic after eastern and southern Africa.

“Among countries with available data, HIV epidemics are growing in Afghanistan, Bangladesh, Fiji, the Lao People’s Democratic Republic, Papua New Guinea and the Philippines,” the report said.

The regional director of UNAIDS Asia Pacific Eamonn Murphy said rising new infections in Fiji “put the entire Pacific region at risk”.

“Prioritisation of HIV by the government is critical for not only the people of Fiji, but the entire Pacific,” he said.

“Political will is the essential first step. There must also be community leadership and regional solidarity to ensure these strategies work.”

UNAIDS said the 1093 cases from January to September was three times as many as there were in 2023.

Preliminary Ministry of Health numbers show that among the newly-diagnosed individuals who are currently receiving antiretroviral therapy, half contracted HIV through injecting drug use. Over half of all people living with HIV who are aware of their status are not on treatment.

Second-fastest growth
“Fiji has the second fastest growing HIV epidemic in the Asia and the Pacific region,” Murphy said.

He said the data does not just tell the story about a lack of services, but it indicates that even when people know they are HIV-positive, they are fearful to receive care.

“There must be a deliberate effort to not only strengthen health systems, but to respond to the unique needs of the most affected populations, including people who use drugs.

“Perpetuating prejudice against any group will only slow progress.”

UNAIDS also said the HIV Outbreak Response Plan called for a combination of prevention approaches.

Since the sexual transmission of HIV remains a significant factor, other key approaches are condom distribution and pre-exposure prophylaxis (PrEP), a treatment taken by an HIV-negative person to reduce the risk of contracting HIV if they are exposed.

UNAIDS support
Through the Australian government’s Indo-Pacific HIV Partnership, UNAIDS is supporting Fiji to scale up prevention approaches.

United Nations Resident Coordinator in Fiji Dirk Wagener said the outbreak declaration and the launch of high-impact interventions, such as needle syringe programmes and PrEP, marked a critical turning point in Fiji’s efforts to combat the epidemic.

“The Joint UN Team on HIV, with UNAIDS as its secretariat, stands ready to provide coordinated and sustained support to ensure the success of these strategies and to protect the most vulnerable.”

The HIV Surge Strategy includes tactics for Fiji to achieve the Global AIDS Strategy targets — 95 percent of all people living with HIV aware their status, 95 percent of diagnosed people on antiretroviral therapy, and 95 percent of people on treatment achieving a suppressed viral load.

This article is republished under a community partnership agreement with RNZ.

Article by AsiaPacificReport.nz