Fiji is facing a significant increase in HIV cases, with the number of people living with HIV increasing by 3091% since 2010, from around 500 in 2014 to an estimated 5900 in 2025. There were 1093 new cases in 2024, triple the number in 2023, and the number of new cases is increasing rapidly, mainly due to needle sharing among injecting drug users. who make up approximately half of newly diagnosed patients. Only 36% of people living with HIV in Fiji are aware of their status and only 24% are receiving treatment. In response to the crisis, the government introduced same-day testing and treatment, education programs and peer support, as well as harm reduction measures. The epidemic is linked to the increased consumption of methamphetamines, which has increased significantly during the COVID-19 pandemic. Fiji declared an HIV epidemic in January 2025 and adopted a national plan to deal with the situation, threatening to overwhelm the health system and threaten regional stability. This situation is part of a wider increasing trend of HIV in some Pacific countries[1][2][3][4][5].