Fiji's HIV crisis: Leadership must step up now

Fiji is facing a growing public health crisis as HIV infections rise and treatment coverage remains dangerously low. Since 1989, more than 3000 people have been diagnosed with HIV in Fiji, yet only about 35 per cent are currently receiving treatment.

Alarmingly, nearly half of those newly diagnosed never enter care, leaving themselves and the wider community at risk.

Last year, Fiji recorded 415 new HIV cases - a sharp rise from 245 in 2022. This surge is particularly worrying among adolescents, with new diagnoses jumping from just six in 2022 to more than 100 in the first nine months of 2024.

This near "45-fold increase" reflects a troubling shift in transmission patterns, with many young people acquiring HIV through injectable drug use - a clear failure of harm reduction efforts.

Even more heartbreaking is the rise in babies born HIV positive. Twenty-three children tested positive in the first three quarters of 2024, with 18 infections linked to mother-to-child transmission. The death of a four-month-old infant is a stark reminder of the gaps in prevention and care that need urgent addressing.

Globally, countries like Botswana have reversed their HIV epidemics. Botswana now achieves 94 per cent treatment coverage and has reduced mother-to-child transmission to below (2) two per cent. Rwanda's decentralised, community-based HIV testing and care reach rural and urban populations alike.

The Philippines, confronting adolescent infection spikes, has embraced peer education, online outreach, and youth-friendly services.

Fiji, however, lags behind. Stigma remains rife. Antiretroviral treatment stock-outs and insufficient training for health workers undermine effective care.

The Ministry of Health's 'Velomani' training programme is a positive step but must be scaled up and made mandatory to ensure consistent, sensitive care.

This is more than a health issue - it is a test of political will. Fiji needs coordinated leadership to implement proven international strategies: decentralised testing, rigorous follow-up systems, and targeted harm reduction for youth and drug users. Laws and policies must protect, not punish, vulnerable groups.

Every untreated adolescent, every child born with HIV, is a preventable tragedy. The time to act was yesterday. The next best time is now.

Let Fiji's HIV crisis not be remembered for silence but for decisive, courageous action.

Feedback: naisak@fijisun.com.fj