Thousands of Bangladeshi workers in Fiji and the country’s rapidly expanding HIV epidemic have prompted global health experts to urge Bangladesh and other Asian nations to strengthen harm reduction and HIV prevention before similar outbreaks take hold.
Speaking at the 26th International AIDS Conference (AIDS 2026), experts pointed to Fiji’s experience as a warning of how quickly HIV can spread when infections among people who inject drugs are not brought under control.
The Pacific island nation, which now employs between 3,000 and 3,500 Bangladeshi workers, has recorded a 14-fold increase in new HIV diagnoses over the past five years.
The outbreak became so severe that Fiji declared a national HIV outbreak in January 2025 after infections spread from people who inject drugs into the wider population.
Responding to a question from Dhaka Tribune, Dr Jason Mitchell, chair of Fiji’s National HIV Outbreak Cluster Response Taskforce, said health authorities are monitoring HIV infections among migrant workers, although nationality-specific data are not available.
Experts said Fiji’s experience carries an important lesson for Bangladesh, where HIV prevalence remains low but continued investment in harm reduction is essential to prevent future outbreaks.
Md Akhtaruzzaman, senior manager for Management and Coordination at the AIDS/STD Program under the Directorate General of Health Services (DGHS), said Bangladesh’s situation differs significantly because most yaba and methamphetamine users consume the drugs orally rather than by injection.
He said Bangladesh has an estimated 34,000 people who inject drugs, about 87% of whom are covered by harm reduction services, including needle and syringe exchange programs and methadone maintenance treatment.
“Our HIV program places strong emphasis on people who inject drugs through targeted harm reduction interventions,” he told Dhaka Tribune.
“Sustaining these services is essential for preventing HIV, sexually transmitted infections and hepatitis C.”
According to UNAIDS data presented at the conference, Fiji’s adult HIV prevalence has reached 1.2%, while the number of people living with HIV has risen from about 8,900 in 2025 to an estimated 12,000 this year.
Nearly two-thirds of new infections are among people aged 20 to 34.
The country’s treatment response has also fallen well short of global targets, with only about 40% of people living with HIV aware of their status, 22% receiving treatment and just 3.2% achieving viral suppression.
Dr Mitchell said the absence of a nationwide needle and syringe program remains one of the biggest gaps in Fiji’s response, allowing HIV transmission among people who inject drugs to continue.
Experts at AIDS 2026 said Fiji’s outbreak illustrates how rapidly HIV can spread beyond key populations if prevention, testing and treatment fail to keep pace with changing patterns of drug use.
They warned that maintaining evidence-based harm reduction programs is far less costly than responding to a rapidly expanding epidemic after it has spread into the general population.
