Updated

Updated · The Guardian · Sep 17

Fiji Declares HIV Emergency After 2,060 New Cases as Meth Use Fuels 12-Fold Surge

Updated

Updated · The Guardian · Sep 17

Fiji Declares HIV Emergency After 2,060 New Cases as Meth Use Fuels 12-Fold Surge

Q: With one in 60 adults infected, what hidden drug practices are fueling Fiji's unprecedented HIV explosion?

Fiji’s HIV surge is being driven mainly by unsafe injecting practices tied to methamphetamine use, especially widespread syringe sharing and a high-risk method known as “koda.” Health officials and UNAIDS-backed assessments say the epidemic began among people who inject drugs and is “not primarily sexual” in origin. More than 42% of known transmission cases are linked to injecting drug use, and among patients starting treatment in 2024 with recorded exposure data, 48% cited injecting drug use as the main route. Researchers found many users inject daily, often share needles and syringes, and frequently lack access to sterile equipment. The most dangerous hidden practice identified is “koda,” in which a user draws blood into a syringe, mixes that blood with drug crystals, and then reinjects it. Because the drug is mixed in potentially infected blood and the syringe is often reused or passed on, it creates an efficient route for HIV transmission. Another practice, “bluetoothing” — injecting blood from one person into another — has received attention, but researchers found it was far less common. Experts say the deeper driver is syringe scarcity. Pharmacies often refuse to sell syringes without a prescription, despite no clear legal basis, pushing users toward reused or shared equipment and even a black market. The result is a fast-moving blood-borne epidemic that has now spread beyond drug-injecting networks into the wider population, including pregnant women and newborns.

3 articles · Updated · The Guardian · Sep 17

One in 60 adults in Fiji is now estimated to be living with HIV, prompting the government to shift from an outbreak response to a national health emergency after a 9 September cabinet decision.
UNAIDS said new infections in Fiji jumped 12-fold between 2010 and 2025, driven by methamphetamine use, unsafe injecting, limited access to clean needles, low awareness, stigma, and weak testing and treatment coverage.
More than 42% of cases with a known transmission route were tied to injecting drug use and over half to sexual transmission; one in 50 pregnant women has HIV.
Of an estimated 9,100 people living with HIV in 2025, only 39% knew their status and 22% were on antiretroviral treatment, underscoring the scale of the response gap.
UNAIDS backed Fiji's emergency move and welcomed planned needle-and-syringe legislation, along with broader efforts to expand prevention, testing and treatment.

Sources

The Guardian1h ago

Fiji Declares National HIV Emergency Amid Surging Cases and Methamphetamine Use

The New York Times5h ago

Fiji Declares National Emergency Over Skyrocketing HIV Cases

CNN1d ago

Fiji declares HIV emergency. One in 60 people now have the virus as drug crisis fuels outbreak | CNN

14 Sources

With one in 60 adults infected, what hidden drug practices are fueling Fiji's unprecedented HIV explosion?

Why are local pharmacies blocking the exact tool that could stop Fiji's devastating HIV epidemic from spreading?

Fiji’s HIV Emergency: Inside the 2026 Surge, Systemic Barriers, and the Fight to Close a 40-22-3.2 Treatment Gap

Overview

Fiji’s HIV crisis escalated rapidly after a government-wide emergency declaration in September 2026, as infections surged among youth and the indigenous iTaukei population. Deep-rooted communal sharing traditions and a growing methamphetamine market led to widespread needle sharing, fueling transmission. Intense religious and social stigma, along with fear of arrest, drove many to avoid testing and treatment, resulting in high mother-to-child transmission rates and frequent shortages of essential medicines. As Fiji’s healthcare system struggled to keep up, looming international funding cuts threatened to worsen the crisis, raising the risk of HIV spreading to other Pacific nations with similarly fragile health systems.

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