Fiji has declared a national emergency as HIV cases surge, and is expanding access to testing, treatment and prevention services.

About one in 60 adults in the tiny Pacific archipelago is now living with the bloodborne virus, compared with one in 167 five years ago, with a rising number of babies dying from HIV-related complications.

The nation of less than a million people saw 2,016 new diagnoses in 2025 alone, Health Minister Antonio Lalabalavu said, noting that "an outbreak-level response is no longer sufficient".

A spiralling trend of drug use, unsafe sex, needle sharing and "bluetoothing" underpins the epidemic, health experts and NGOs earlier told the BBC.

"Bluetoothing" or "hotspotting" refers to the dangerous practice where intravenous drug users inject the blood of already intoxicated individuals, which has fuelled a global HIV surge, especially in parts of Africa and in the Pacific.

One reason for its appeal is a cheaper high: multiple people can chip in for a single hit and share it among themselves. Another is the convenience of needing only one syringe, which are difficult to come by in Fiji.

The Fijian government will introduce a syringe and needle programme as part of its response to the national crisis.

The country already has sufficient supplies of syringes and needles, Lalabalavu says, with legislative amendments to be introduced in parliament so that the programme can be rolled out.

The minister also urged people to come forward and get tested.

"No one should be ashamed, threatened, or excluded because of their HIV status," he said. "Stigma drives people away from the very services that can help them."

Of the 9,100 Fijians living with HIV in 2025, only 39% knew their HIV status and just 22% were accessing antiretroviral treatment, according to the Joint United Nations Programme on HIV and Aids (UNAIDS).

This stands in stark contrast to the global average, where 78% of people with HIV are accessing treatment.

Jason Mitchell, who leads the national HIV response taskforce, believes it will take "upwards of five years for [Fiji] to get on top of the epidemic".

"It's a long-term programme, it's not something like Covid that's turned around in two years. HIV is very different," he told ABC News is an interview.

The HIV epidemic has led to a strain on Fiji's health services, Mitchell said. "For a health system that's already struggling, to have people who should really be well because there's treatment available taking up beds in hospitals and sitting in outpatient... Our clinical services has really been under a lot of pressure."

UNAIDS has welcomed Fiji's emergency declaration, saying it signals the urgency needed to ramp up response to a higher level across government and society.

"It is also 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," said the executive director of UNAIDS Winnie Byanyima.