Fiji has declared a national HIV emergency amid a sharp spike in infections, as the Pacific island nation grapples with a parallel rise in methamphetamine use.

Health and Medical Services Minister Dr Ratu Atonio Lalabalavu announced the declaration in a social media statement, saying an outbreak-level response was no longer sufficient to address what he described as an "epidemic."

"Today I am formally declaring a national health emergency in Fiji," he said. "This decision recognises the seriousness of the epidemic and the urgent coordinated response our country now needs."

The minister said the government estimates that one in every 60 adults in Fiji is now living with HIV. "Five years ago, the estimate was one in 167. In 2025, we recorded 2,060 new HIV diagnoses," he said, adding that one in 50 pregnant women has HIV.

The emergency declaration followed a cabinet decision on 9 September and will require a coordinated national response, the minister added.

Home to fewer than one million people, Fiji is facing one of the sharpest increases in new HIV infections globally. According to UNAIDS, new infections spiked 12-fold between 2010 and 2025.

Fiji's role as a drug-trafficking hub, combined with escalating local methamphetamine use, has fuelled the rapid spread of HIV. The crisis has been worsened by unsafe injecting practices, a lack of access to clean needles, low health awareness, cultural stigma, and inadequate testing and treatment.

Among HIV cases in Fiji with a known mode of transmission, over half were linked to sexual transmission and more than 42% to injecting drug use, according to UNAIDS.

Of an estimated 9,100 people living with HIV in Fiji in 2025, only 39% were aware of their status and only 22% were accessing antiretroviral treatment, the UN agency said.

UNAIDS Executive Director Winnie Byanyima responded to the declaration on Wednesday, calling the situation "a stark reminder to the world that AIDS is not over."

"HIV epidemics can change quickly, and countries need health and community systems that are ready to respond urgently," Byanyima said. "Fiji has recognised the urgency of the moment and is stepping up its response."

UNAIDS said it welcomed plans to introduce a needle and syringe programme, with legislative amendments expected to go before parliament, as well as broader efforts to expand prevention, testing, and access to treatment.