Fiji is experiencing one of the world’s fastest-growing HIV epidemics with implications that extend beyond its borders and Aotearoa New Zealand must step up its response, according to public health researchers.
Writing for the Public Health Communication Centre Briefing, Dr Sharon McLennan (Victoria University of Wellington) and co-authors say that travel, migration, labour and family links with Fiji mean the epidemic also threatens health here and across the Pacific.
Dr McLennan says what was once a relatively minor public health concern has evolved into a public health crisis, with an estimated HIV prevalence of 1.6% among Fijian adults, a 14-fold increase in infections over the past five years. Among pregnant women, prevalence is 2%, with one child born with HIV every week and one lost to HIV every month.
She says NZ’s existing response is focused mainly on monitoring and communication but needs to be expanded to include prevention and support services.
“NZ has taken positive steps. However, we must strengthen our response to support the Pacific community we are part of and stop Fiji’s epidemic from becoming a region-wide epidemic.”
She says the epidemic highlights the deep interconnections between Pacific and NZ health outcomes. Fiji’s position in the Pacific as a regional transport, education and business hub, and the close family and cultural connections between Fiji and NZ, mean people move regularly between both countries, contributing to shared public health concerns.
The researchers say that NZ agencies have already recognised the epidemic as relevant to domestic public health. NZ has made substantial progress under the National HIV Action Plan, which aims to eliminate local HIV transmission and AIDS-related deaths by 2030, and Health NZ officials have expressed concern that the epidemic in Fiji could undermine these gains.
Dr McLennan and co-authors’ Briefing outlines key gaps in NZ’s existing efforts. They say to strengthen the response, NZ should invest in expanding Pacific-led engagement and leadership, as well as culturally safe HIV prevention, testing and support services for Pacific communities that are designed with Pacific communities.
NZ must also increase long-term financial and technical support for Pacific HIV prevention and treatment systems to improve regional health outcomes and reduce risks for NZ.
“HIV is a Pacific regional health security issue, and we need to better integrate responses across health, development and foreign policy sectors,” says Dr McLennan.
“Fiji’s HIV epidemic is a reminder that NZ’s future health is linked to that of its Pacific neighbours. The challenge now is to build a response that reflects that reality by pairing regional solidarity with stronger support for Pacific communities here in Aotearoa.”