Fiji passes law to distribute sterile needles amid HIV crisis

The Fiji parliament passed an amendment to the HIV/AIDS Act of 2011 on 1 October to allow the Health Minister to authorize the distribution of sterile injecting equipment.

This legislation makes Fiji only the second Pacific island nation, after Papua New Guinea, to establish a formal needle and syringe programme. The move addresses a rapidly growing HIV epidemic that has seen cases increase twelve-fold since 2010 and four-fold in just the last three years.

The Health Ministry estimates that one in 60 adults in Fiji now lives with HIV. In 2025, the country recorded 2,016 new diagnoses, its highest annual total, and 117 HIV-related deaths. Data shows that more than 42% of cases with a known transmission route are linked to injecting drug use, specifically crystal methamphetamine. A study by the Australian Kirby Institute found that every participant in a recent assessment had reused a needle because sterile ones were unavailable.

Jason Mitchell, Chair of the National HIV Outbreak Cluster Response Taskforce, noted that police crackdowns on pharmacies previously made needles hard to find, encouraging people to share equipment. To implement the new programme, Mitchell secured support from traditional leaders, opposition parties, and faith-based organisations. The initiative also includes a peer education pilot funded by the Australian Government Department of Foreign Affairs and Trade.

This pilot employs community workers who visit injecting hotspots to provide harm reduction information, though these workers face risks because laws do not yet explicitly protect them from being identified as drug users.