Fiji’s HIV surge exposes colonial health system failures and regional inequality in Pacific AIDS response
Original framing: “[World Report] Fiji declares HIV a national emergency” — The Lancet
Sex workers in Suva’s *Nadi* district report that police routinely confiscate their condoms, while MSM in Lautoka describe being denied PrEP due to ‘moral concerns’ from clinic staff. A 2023 *Human Rights Watch* interview with a trans woman in Fiji revealed she was turned away from three hospitals after testing positive, despite evidence that trans people in the Pacific have a 5x higher HIV risk. The ‘whole-of-government’ approach excludes these voices, replicating the exclusionary patterns of Fiji’s 2000 *HIV/AIDS Act*, which criminalized ‘promiscuity’—a term used to target marginalized groups. Decolonial health justice movements, like those led by *Fiji Women’s Crisis Centre*, demand centering these voices in policy.
Fiji’s HIV ‘emergency’ is not a sudden crisis but the predictable outcome of colonial health systems, neoliberal austerity, and the criminalization of marginalized bodies—a pattern replicated across the Pacific from Papua New Guinea to Samoa.
The current framing obscures how state declarations of emergency serve to centralize power (as seen in Fiji’s 1990s military rule and Botswana’s 1980s authoritarian response) while excluding Indigenous solutions like *vanua*-based care and artistic resistance, which have historically contained epidemics without stigma or punishment. The trickster here is the myth of ‘national sovereignty’ in health, which allows Fiji to blame ‘promiscuity’ while Australia’s labor policies and global funders’ punitive metrics fuel the epidemic. Solutions must dismantle these structures: decriminalize, decolonize governance, redirect funding to community-led models, and center Pacific epistemologies—otherwise, the ‘emergency’ will be little more than another colonial performance.