Authorities have declared the epidemic a national public health emergency.

For years, the more than 330 islands that make up Fiji had almost zero HIV cases. But over the past five years there has been a 14-fold increase in infections.

According to the Lowy Institute, Fiji recorded 1,583 new HIV cases in 2024, an incidence of about 158 per 100,000 people. By comparison, Australia, a nation with around 27 times the population of Fiji, had just 757 new cases in 2024 (2.9 per 100,000 people).

Fiji’s new HIV cases have increased by 1,219 per cent between 2019-24, contrasting with global trends of a steady decline since the mid-1990s. This trajectory shows no signs of slowing down.

Fiji now has the unenviable title of having the fastest-growing HIV epidemic in the world. Yet, the figures likely underestimate the extent of Fiji’s HIV crisis due to poor testing rates. Only a third of people living in Fiji know their status and only about a quarter receive treatment.

“What is driving this epidemic now is risky injecting drug use of people who currently inject methamphetamines,” said Dr Jason Mitchell, chair of Fiji’s National HIV Outbreak Cluster Response Task Force.

The Pacific islands – positioned between East Asia, the Americas, Australia and New Zealand – have long been a gateway for drug traffickers. But during COVID-19, the drugs were unable to move, and a domestic market for crystal meth grew, experts say.