Drug Use Driving HIV Surge In Fiji
The United Nations says Fiji's "drug-driven" HIV surge last year, which claimed the lives of 126 people, is a "case of complacency".
UNAIDS Pacific adviser Renata Ram told Pacific Waves that eight children were among those who died from HIV-related illnesses in the country last year.
She said that in 2024, Fiji recorded its highest-ever annual total of HIV cases - 1583 new diagnoses - representing a 281 percent increase from 2023.
"The response here in Fiji is about 15 years behind what is needed. We're still not getting testing done within a shorter period of time."
She said that assessments done by the country's Health Ministry show that it takes about 22 days for a person to get their HIV results, on average.
The epidemic is also getting younger: 76.7 percent of all new infections last year were among those aged 18-34, with 165 cases among 15-19 year olds, and 41 cases among children younger than 15.
The main factor behind the sudden surge, with most cases concentrated in Fiji's Central Division, has been injecting drug use, Ram said.
"In terms of mode of transmission, 48 percent of known modes of transmission of cases were due to injecting drug use, with around 40 percent through sexual transmission. So injecting drug use is emerging as a major health threat and it's not addressed."
In the recent past, Fiji has been able to manage HIV levels through community-led programmes benefitting from donor funding.
Ram said that over the past few years a donor exodus has put more pressure on an already struggling health system.
This has pushed HIV to the top of the priority list for Fiji in its pleas for aid across the developed world, with Australia adding FJ$5.7 million to a $38m package targetting health infrastructure.
Ram said that New Zealand, which had an estimated two HIV-related deaths in 2024, has shown what an effective community-led approach can look like.
"New Zealand was the first country in the world to start with harm reduction and needle exchange programs...people who use drugs, sex workers and young people connect better with their own communities."
Budget funding a good start
The government has allocated FJ$10m to tackle the country's surge in HIV/AIDS to the Ministry of Health & Medical Services in its 2025/2026 budget. This is out of the health sector's total allocation of FJ$611.6m.
Ram commended this action but said that much more needs to be done.
"The Fijian government has estimated the need for about FJ$14m over the next four years to really get ahead of the curve, because it's not about only addressing the HIV outbreak, but it's also about system strengthening."
Hospitals often run out of drug supplies because they underestimate the number of cases they receive thanks to quality of data, Ram said.
"We're having problems with quantification, knowing how much drugs we need for people that need treatment. So this becomes an issue, and we are having lots of stock out as well.
"60 [of the 126 deaths] were late diagnosis, so they were diagnosed and passed away within a short span of time."
The Ministry of Health in Fiji has yet to release data for the 2025 year to date.
The Fiji Medical Association (FMA) has raised alarm bells over these data gaps.
The association's president Dr Alipate Vakamocea told FBC that the country is "flying blind".
"We are in an active outbreak. This is not normal and the issue that we have is, you know, we did that during Covid-19. It's dispersed. We declared an outbreak earlier this year. We're still referring to statistics from 2024."
Minister of Health Dr Atonio Lalabalavu said there will be "monthly or quarterly" data updates soon.
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