Fiji has declared a national HIV emergency as the Pacific island nation confronts a sharp increase in new infections, with injecting drug use emerging as a major factor in the country’s changing HIV landscape.
The emergency declaration comes amid growing concern over unsafe injecting practices and limited access to sterile needles and syringes. Health authorities have warned that people who inject drugs face heightened exposure to HIV and other blood-borne infections when injecting equipment is shared.
The Brandspur News report found that a 2025 assessment of people who inject drugs in Fiji highlighted widespread reuse of needles and syringes. All 56 participants interviewed reported having reused injecting equipment after another person at some point, underscoring the risks facing people who use drugs.
One practice that has attracted particular attention is known as “bluetoothing”, in which drug users share drug-contaminated blood after an injection. While the practice has generated significant media attention, the assessment found limited evidence that it was widespread among the people interviewed.
Fiji recorded 2,016 newly registered HIV cases in 2025, its highest annual figure since surveillance began. Health officials have cautioned that increased testing and improved surveillance also contributed to the rise in recorded diagnoses.
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Among cases where the mode of transmission was reported, 18 per cent were linked to people who inject drugs, while a substantial proportion had no recorded transmission route. The figures have nevertheless placed injecting drug use firmly among the issues confronting Fiji’s HIV response.
The scale of the epidemic has also exposed gaps in treatment and prevention. Estimates indicate that thousands of people are living with HIV in Fiji, while a relatively small proportion are aware of their status or receiving antiretroviral treatment.
Authorities are responding with measures aimed at expanding HIV testing, treatment and prevention, including plans to introduce needle and syringe programmes. Such interventions are intended to reduce the risks associated with sharing or reusing injecting equipment while connecting vulnerable drug users with healthcare services.
The health implications extend beyond HIV. Sharing contaminated injecting equipment can transmit hepatitis B and hepatitis C, as well as expose users to other serious infections.
Fiji’s experience has also drawn attention to the role of stigma and limited access to healthcare in controlling HIV transmission. Public health agencies have stressed the need to reach people who inject drugs with confidential testing, prevention services and treatment rather than leaving vulnerable groups outside the formal healthcare system.
The government is now implementing a national HIV surge strategy and outbreak response measures as it seeks to contain the rise in infections and expand access to prevention and treatment across the country.
