Fiji faces world's fastest‑growing HIV epidemic

Fiji, a Pacific island nation of about 937,000 people, has been identified as having the fastest‑growing HIV epidemic globally. Over the past five years infections have risen roughly fourteen‑fold, with UNAIDS estimating around 12,000 people living with HIV in 2025 – about 1.2% of adults aged 15‑49.

The surge is driven primarily by the rapid expansion of injectable methamphetamine use. Nearly half of recent infections are linked to needle sharing among people who inject drugs, a practice that intensified after COVID‑19 disrupted international drug trafficking and spurred a domestic market. In January 2025 the government declared a national HIV outbreak, noting that the disease has spread beyond the injecting‑drug community into the wider population.

Vertical transmission rates are alarmingly high, exceeding 2% among pregnant women and reaching 18% last year – the highest in the world. This has resulted in an average of one child born with HIV each week and one child dying from HIV‑related causes each month. The epidemic disproportionately affects the indigenous iTaukei group, accounting for about 94% of cases. Health officials cite a lack of harm‑reduction resources and delayed implementation of prevention programs as key challenges.

Dr Jason Mitchell, chair of Fiji’s National HIV Outbreak Cluster Response Task Force, warned that the crisis is preventable and called for urgent scale‑up of testing, treatment, and needle‑exchange initiatives.