Fiji’s lawmakers have passed legislation allowing the rollout of a needle exchange programme aimed at containing the rapid rise of HIV from intravenous drug use.

The HIV/AIDS (Amendment) Bill 2026, which will introduce evidence-based harm reduction programmes, is being hailed as a “lifeline” for the country.

Fiji now joins Australia, New Zealand and Papua New Guinea as the only Pacific nations with a formal needle and syringe programme.

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Following the passing of the Bill by Parliament on Thursday, Fiji’s Health Ministry described it as a “monumental milestone” in the fight against HIV/AIDS.

Fiji has one of the fastest-growing HIV rates in the world, with the government declaring an HIV emergency last month as one in 60 Fijian adults is now living with the virus.

“To be clear: this does not legalise illicit drugs,” the Ministry said in a Facebook post.

“It legalises compassion. It builds a protective bridge of healthcare to the most vulnerable among us.”

Grounded in human rights
The Health Ministry said the legislation was grounded in human rights, confidentiality, and freedom from discrimination.

“It allows our frontline health heroes, pharmacies, and peer outreach workers to distribute sterile equipment, condoms, PrEP, and life-saving counselling safely and without fear.”

Fijian Health Ministry Dr Atonio Lalabalavu said the Bill sets out what harm-reduction may permit.

“This includes the free distribution of skin-penetrating instruments, including needles and syringes, condoms and condom lubricants, Pre-exposure prophylaxis (PrEP), and other means of HIV prevention,” he said.

“It may also provide facilities for the safe return and management of used items, targeted counselling, information in HIV/AIDS awareness and materials, and referrals to HIV treatment, rehabilitation, mental health and other health and social support services.”

The Bill also allows other measures to be approved by the health minister on the recommendation of the HIV/AIDS Board where those measures are necessary, Dr Atonio added.

Fiji’s Health Minister Dr Ratu Atonio Lalabalavu has formally declared a national HIV emergency in the country.

In a pre-recorded video press statement on Tuesday, Dr Lalabalavu said the decision was backed by Prime Minister Sitiveni Rabuka and his Cabinet due to the “seriousness of the epidemic”.

The health minister confirmed that the government’s current estimates indicated that one in every 60 adults in Fiji is living with HIV.

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“Five years ago, the estimate was one in 1667. In 2024, we recorded 2060 new HIV diagnoses,” he said.

“HIV prevalence among women attending antenatal care reached around two percent. That means one out of 50 pregnant women now has HIV. These figures tell us the response must reach further and follow through more consistently.”

This week, a health researcher told RNZ Checkpoint that a “horrendously high” number of newborns were dying due to HIV-related complications in Fiji.

The NZ government’s SafeTravel website is warning people traveling to Fiji to avoid activities that could increase their risk of infection.

Second-fastest growth in Asia-Pacific
According to the World Health Organisation (WHO), Fiji has the second-fastest-growing HIV epidemic in the Asia-Pacific region behind Papua New Guinea (PNG).

An estimated 9000 Fijians were living with HIV as of March this year, and officials pointed to high-risk drug use contributing to the rapid rise.

Dr Lalabalavu said every diagnosis must lead to care and every person starting treatment needed support to remain on it.

He said authorities would move quickly to introduce new interventions and scale up established services backed by evidence.

“That means expanding testing, treatment, and access to pre-exposure prophylaxis, or PrEP. It also means accelerating the introduction of a formal needle and syringe programme and long-acting injectable prevention.”

He stressed that treatment was central to the government’s response.

“It helps people living with HIV stay well, and when it achieves and maintains an undetectable viral load, it prevents sexual transmission.”

Coordinated implementation
Fiji’s Sexual Reproductive Health and HIV Programme Management Unit is expected to coordinate implementation, working through divisional and sub-divisional health services, and with community partners.

Dr Lalabalavu said Australia, New Zealand, the Global Fund, India, and the United Nations Joint Team on HIV and AIDS, and other partners were supporting the country with its HIV response.

The Fijian government had also proposed the establishment of a parliamentary standing committee on HIV and related matters, he said.

“To anyone who has been diagnosed with HIV, a diagnosis does not take away your future. Effective treatment can help you live a long and healthy life. Keep taking your medicine as prescribed, even when you feel well.

“I call on families, communities, faith leaders, schools, employers, and partners to join in this response, encourage testing, support people to stay in care, and challenge stigma wherever you encounter it.”

Fiji is now in a generalised HIV epidemic, which means the virus is firmly established and spreading within the general population.

The number of people living with HIV in Fiji has risen sharply over the past decade.

Fiji’s Health Minister Dr Ratu Atonio Lalabalavu declared an HIV outbreak in January 2025.

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The number of Fijians living with HIV had risen to at least 9000, or nearly 1 percent of the population, as of March, according to the head of Fiji’s HIV response.

The figures indicate that Fiji has a higher HIV prevalence rate than Australia and New Zealand, where the rate is estimated at 0.1 percent.

In Parliament this week, the Health Minister revealed that new infections continued to rise, with an estimated 1700 in 2025, roughly three times the level in 2018.

“2026 UNAIDS estimates indicate that about 9100 people were living with HIV in 2025, and possibly as many as 12,000, up from fewer than 700 in 2010,” he said.

“[For] adults from 15 to 49 years, prevalence has reached 1.6 percent, crossing the threshold that defines a generalised epidemic.”

Dr Lalabalavu said his ministry had increased testing and treatment, but Fiji had not yet reached the point where new infections were declining.

He said the government was expanding HIV testing, treatment and prevention, including PrEP, a daily medicine that helps prevent HIV.

The minister noted that high-risk drug use, in particular sharing of needles and syringes, was playing a significant role in the rapid rise of new HIV infections in Fiji.

“We have not yet reached the turning point,” he said.