HIV in Fiji is currently the second-fastest growing epidemic in the Asia-Pacific region, experts say. Reports show that since 2010, new infections in the country have increased by a whopping 129 per cent while Papua New Guinea cases had hiked by 49 per cent.
This is startling news since, only as recent as 2021, Fiji was on top five spot. It triggers fresh calls from leaders in the area of Pacific health for urgent action to address the alarming increase in the region’s HIV figures.
Pacific leaders have been encouraged to jointly address the region’s growing HIV vulnerability through investments in ‘proven prevention, testing, treatment and care approaches’.
During the recent 14th Pacific Heads of Health Meeting held in Fiji last week, health senior advisers learned of the rising AIDS-related deaths across the region, particularly the ‘increase in new infections in Fiji and PNG’ which place ‘the entire Pacific at risk’.
The first face-to-face gathering since the pandemic, it became the first time since 2015 for HIV to be on the meeting agenda.
It heard calls for bold and coordinated action to scale up prevention for young people, reduce new infections among key population communities, eliminate mother-to-child transmission and expand access to antiretroviral therapy for people living with HIV.
Data made available by the United Nations Population Fund (UNFPA) highlighted the Pacific’s high levels of sexual and gender-based violence, which continues to increase the HIV/STI transmission risk among vulnerable populations including young women.
According to UNAIDS estimates, Fiji and Papua New Guinea are among 38 countries globally with rising HIV infections.
The Pacific Islands Regional Multicountry Coordinating Mechanism (PIRMCCM) which provides oversight for the implementation of the Global Fund grants to address HIV, tuberculosis and malaria has expressed concerns alongside UN agencies like UNAIDS, UNDP and the WHO.
‘We draw particular attention to Fiji as it is currently the second fastest growing epidemic in the Asia-Pacific region. Given the vast migration of young people to Fiji from other Pacific Island countries, if unaddressed there could be serious implications,’ said PIRMCCM Chair, Dr Frank Underwood.
‘This represents a significant threat to the health of other Pacific countries due to the high mobility between countries, low condom use and absence of innovative HIV prevention strategies,’ Dr Underwood explained.
Not too far back, 2021 in particular, former Speaker of the Fijian Parliament and UNAIDS Goodwill Ambassador for the Pacific Region, Ratu Epeli Nailatikau said that according to the Global AIDS Monitoring Report, Fiji was among the top 5 countries of rising new HIV infections in the Asia Pacific region, among the 15–24-year-old age group, and with an increasing rate of over 50 per cent since 2010.
This had put Fiji ahead of all other Pacific Island countries. A year earlier, in 2020, Fiji had a total of 147 new cases and 13 of these cases were pediatric cases. Cases were were mostly opportunistic, meaning that there wasn’t active outreach done for testing.
‘This could indicate that there are many unknown cases out there – a trend that is common throughout the world,’ Ratu Epeli said. He said the Fiji statistics were unacceptable and urgent action was needed.
In May last year, Fiji’s Ministry of Health revealed there were 151 new cases of HIV recorded (for 2021), most of them belonging to the younger population bracket. The main mode of transmission was through unsafe sex practices.
Furthermore, some of the newly diagnosed cases had indicated to be injecting drug users and were sharing needles with others, another emerging mode of HIV transmission made popular by the increase in the use and trade of synthetic drugs like amphetamine or ice.
From the 151 reported HIV infections in 2021, 82 per cent were from the ages of 20 to 49 years, 6 per cent were adolescents and 6 per cent were less than 10 years of age reflecting 9 mother to child transmissions.
The health ministry then said this had been the highest number of reported annual HIV infections since the first reported case in 1989. Between 1989 and 2021 there had been a cumulative number of 1417 cases of HIV reported in Fiji.
Consequently, Permanent Secretary for Ministry of Health and Medical Services and the Chair for the HIV Board, Doctor James Fong appointed a working group consisting of senior HIV medical staff and development partners such as UNAIDS to escalate efforts by the HIV program to counter these rising numbers.
Doctor Fong said the escalated efforts need.’ were to cover all focus areas starting Pacific countries are being encouraged to exercise increased ownership of from prevention, data management, testing, treatment and the delivery of care.
As it stands now, the continued increases despite the many efforts to arrest them make the 2025 HIV targets agreed through the 2021 political declaration on HIV and AIDS and the Global AIDS Strategy impossible to achieve for the Pacific.
Last week’s Pacific Head of Health meeting heard our targets were ‘offtrack’.
Among other reasons, the situation has been compounded by ‘declining resources for health and HIV, shifting donor priorities, weakened health systems and economic challenges’ worsened by the COVID-19 pandemic.
It should be noted also that in the last decade, political, public and donor focus had shifted from HIV and AIDS, in favour of more pressing needs in the developing world and the requirements to attain MDG targets and more recently, climate action ambitions and COVID-19 responses.
These have contributed to the reversal of many earlier gains.
UNAIDS Country Director for Fiji and the Pacific, Renata Ram says this has created a knowledge gap.
‘The impact of this is that the Pacific now has a generation of young people with low HIV knowledge, poor HIV testing uptake, low condom use, high levels of stigma and discrimination and poor comprehensive sexuality education,’ said Ram.
‘Young people are increasingly using online spaces for sexual networking. We need innovative strategies to help them access the information and services they Pacific countries are being encouraged to exercise increased ownership of the HIV response, including by targeting more domestic funding into community led and delivered services.
Targeted interventions are required to reach key populations such as men who have sex with men, people who use drugs, sex workers and transgender women with services.
Also, devising appropriate health services, sexual health education, and supportive social and economic conditions should be looked into to reduce the Pacific’s vulnerability to HIV infection and strengthen the skills communities need for effective protection.
Our leaders need to move beyond complacency and denial, and work on a regional integrated response.
At nation level, governments will need to have the political will to tackle high risk behaviors and work more closely with key stakeholders, recognising that to combat HIV and AIDS will require more than just prevention and treatment.
‘No Pacific nation is safe unless we are all safe,’ Ms Ram said.
‘Through joint action around prevention, testing, treatment and community support, we can achieve the Sustainable Development Goals target of ending AIDS by 2030.’
The Pacific Heads of Health meeting, aimed at addressing the current state of health services in the Pacific region, was held on Denarau Island, Nadi between April 25 and 28. The next meeting is scheduled for September 20-22, in Tonga.
