Fiji’s HIV Crisis Could Spread Across The Region, Health Experts Warn

Tiana
Haxton, RNZ Pacific journalist

Health
experts are warning that Fiji’s rapidly rising HIV infection
rate – described
as a “national crisis” – could spread across the Pacific
if urgent action is not taken.

According to Dr Jalal
Mohammed, a senior lecturer at the University of Canterbury
and adjunct professor at the University of Fiji, the crisis
has reached a “tipping point”.

The Fijian Health
Ministry has predicted more than 3000 new cases will be
reported this year, but Dr Mohammed said that figure barely
scratches the surface.

“In conservative societies,
where there’s a high stigma attached to the virus, there’s
going to be a significant number that goes unreported,” he
said.

“We’ve got estimates of about 45 percent
[more]… so we’re going to be looking at about 4500 to 5000
new cases this year. That is staggering for a small
country.”

With such high numbers, he said the rest of
the Pacific is at risk.

“The region should be
preparing for transmission of cases across borders. Fiji is
a gateway country to other Pacific Islands. It is a major
tourism hub. We’re not going to be immune from what happens
in Fiji.

“People going on holidays could pick up the
virus. We could see an increased number of cases in New
Zealand as well.”

Dr Mohammed said the illicit drug
trade is fuelling the surge in infections.

He said, as
well as being a travel hub, Fiji’s geographical location
places it “at the heart of the drug trade super
highway.”

While most drugs brought into the country
move through to Australia and New Zealand, they also flow
into the domestic market, he said.

“That’s driving it,
because it is IV (intravenous) related. Intravenous needle
sharing, there’s chem-sex, bluetoothing. It is the increase
of drug usage in Fiji that is predominantly spurring the
increase in cases that we’re seeing.”

He said the
practice of “bluetoothing”, where one user takes drugs, then
withdraws their blood and injects it into others, has become
more common due to poverty and limited access to addiction
services.

‘Culture of silence, stigma’

Dr
Sharon McLennan, a senior research fellow at Victoria
University in Wellington, said a lack of education on how
HIV and AIDS is spread is also an issue.

“We have a
generation who’ve grown up with that culture of silence and
stigma, not talking about it, also not hearing about it,
through the health services, through the education
services,” she said.

“Many people don’t understand how
HIV is transmitted, they don’t understand STDs (sexually
transmitted diseases). And that’s why we then see the rise
of things like bluetoothing and people have no conception of
the risk because they don’t know how these how viruses are
transmitted.”

Alongside cultural stigmas and taboo,
she said this gap in education is due to a lack of funding
and resources.

She said the country’s health system
has been struggling to respond for years.

“Fiji has
had a fairly unstable political history in the last few
decades, and the health system suffered through a lot of
that.

“If you’ve been to Fiji and been around the
hospitals, the infrastructure is very old. It’s not able to
be well looked after. Staffing issues have been a problem
over the years that are getting worse.

“We have a
health system with limited capacity to address a
crisis.”

University of Fiji’s head of nursing
Professor Akisi Ravono said the response must include
cultural and community leadership.

Professor Ravono
said by involving the traditional vanua system, the
community stigma can be overcome.

“We must incorporate
traditional chiefs, the elders and the community leaders to
get an effective HIV response running,” HE
SAID.

“These are the people who hold authority and
influence within the indigenous Fijian communities…
getting them to be educated on drugs and the risky
behaviours, they can take that back to their communities and
take responsibilities for the well being of their
people.”

She said empowering those leaders could help
drive awareness in deeply conservative
communities.

“It’s considered as a taboo to talk about
sex… that adds to the burden itself, so people are not
aware of how they can get HIV, what are the modes of
transmission.”

Health leaders from 38 countries met in
Fiji last week for the 76th session of the World Health
Organisation Regional Committee for the Western
Pacific.

A side conference focused on tackling HIV and
AIDS across the region.

UNAIDS regional support teams
director Eamonn Murphy said less than half of the people
living with HIV in Fiji are receiving
treatment.

Murphy said “epidemics are growing while
donor investments fall”.

“What story will we tell
about HIV? Will the dream of ending AIDS by 2030 be
realized, or will it fail at the foot of funding cuts and
complacency.

“Although we know what to do, our efforts
are not meeting the moment, just when targeted prevention
programs for communities are most needed, support is
dwindling… this could form the perfect storm that derails
the goal of ending AIDS.”

He said the region needs
more sustainable funding to beat HIV and AIDS.

The WHO
says it is vital that governments, civil societies and
communities work together

It said a stigma and
discrimination free environment is crucial to eradicate HIV
and AIDS across the region.

Despite the grim
statistics, all three experts share a collective
hope.

“Fiji is quite a resilient country,” Dr Mohammed
said.

“There is a dedicated team of health
professionals… they just need to have the resources to be
able to do their jobs.”

Ravono said success lies in
the community itself: “With interventions engaging the
vanua leaders, I think we have hope.”

For Dr
McLennan, it is Fiji’s cultural strength that gives her
confidence.

“Fiji has a strong culture… people are
really well connected to each other, to the Vanua. This is a
country where people stand together. They see a fight and
they’ll fight it
together.”

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