Fiji's government has declared the country's HIV outbreak a "national crisis," a dramatic escalation less than two years after health officials first declared it an "outbreak," as new infections surge and the Pacific nation's epidemic climbs to one of the highest rates on Earth.

The Cabinet's decision, announced this week, comes after 2,016 new HIV diagnoses were recorded in 2025 — up sharply from 1,583 the year before, according to the Pacific Islands News Association. Fiji now has an estimated 3,535 people living with HIV, of whom 1,979 are on antiretroviral therapy.

The human cost has been steep: 117 people living with HIV died in 2025, including 17 children under 15. Sixty-seven children were newly diagnosed last year, 59 of them through mother-to-child transmission, according to figures reported by the Fiji Sun.

A generational and ethnic divide

Infections among 10-to-19-year-olds jumped 45% in a single year, and roughly two-thirds of all new cases are among Fijians aged 20 to 34. About 90% of new diagnoses are concentrated among the Indigenous iTaukei population, and roughly 40% of people newly diagnosed have not yet entered care, according to Fijivillage.

Health officials point to a cluster of compounding drivers: rising methamphetamine use and needle-sharing, disruptions to donor and government funding for prevention programs, and persistent stigma that keeps people who test positive from seeking treatment. Combined, they have pushed Fiji's HIV rate to the third-highest in the world, trailing only South Africa and Mozambique.

"CABINET HAS ENDORSED DECLARING THE HIV OUTBREAK A NATIONAL CRISIS."

— Fiji Minister for Information Lynda Tabuya, speaking on behalf of Prime Minister Sitiveni Rabuka

Tabuya said government funding and support from international development partners were already being redirected toward the response, though officials have not yet detailed the full scale of new spending. The Ministry of Health is expected to lay out a scaled-up response in the coming weeks, including proposals for needle and syringe exchange programs aimed at curbing transmission tied to drug use.

Fiji's outbreak has drawn growing attention from regional and international health bodies, which have flagged the Pacific nation as a case study in how quickly an HIV epidemic can accelerate once it takes hold in a population with limited testing infrastructure and high stigma. The "national crisis" label is expected to unlock emergency-level government resources and faster coordination between ministries than the outbreak designation allowed.

What's next: health officials are due to detail an expanded prevention and treatment strategy, including expanded testing, further antiretroviral rollout and the proposed needle-exchange programs, as Fiji tries to reverse a trajectory that has more than doubled diagnoses since the outbreak was first declared.