A senior health official has warned that Fiji’s HIV prevention strategies are outdated and must be urgently overhauled, as decades-old approaches fail to meet what she called a growing public health crisis. Dr Dashika Balak, the Principal Medical Officer for Sexual and Reproductive Health and HIV at the Ministry of Health and Medical Services, delivered the appeal during a cultural dialogue at Fiji National University’s College of Medicine, Nursing and Health Sciences in Tamavua on Monday.
“We have to understand and we have to acknowledge that the response that we have currently, the response that we have for decades, are not suited for the current crisis we are facing,” Dr Balak told the forum. She said traditional prevention messaging based on abstinence, fidelity and condom promotion — the so‑called ABC approach — is no longer sufficient. “When I talk about prevention… this does not work in this day and year,” she said.
Dr Balak highlighted one practical consequence of that failure: condom use remains very low across the general population. “The last figures show us that out of the general population, less than 20 per cent use condoms, despite condoms being available free of charge,” she said, arguing behavioural approaches alone will not stop new infections if uptake of prevention tools is poor.
As an alternative, Balak pressed for a shift toward evidence‑based biomedical and harm‑reduction strategies. She called specifically for scaled access to pre‑exposure prophylaxis (PrEP) and post‑exposure prophylaxis (PEP) and for harm‑reduction measures “that include needle‑syringe program” for people who inject drugs. According to Balak, these interventions offer more reliable protection for individuals at higher risk than relying on behaviour change messages alone.
Balak also warned that entrenched stigma around HIV remains a major barrier to prevention and care, deterring people from testing, seeking treatment and using prevention services. She urged community engagement and culturally appropriate approaches to reduce fear and discrimination, saying stigma must be tackled in tandem with expanding biomedical services.
Her remarks, delivered at a university event focused on culture and health, mark the latest public call from a senior official for a modernised national HIV response. Balak did not lay out a specific implementation timeline or detail immediate policy moves by the ministry. Her appeal sets the agenda for health authorities and community partners to consider whether and how to integrate PrEP, PEP and needle‑syringe programmes into Fiji’s prevention portfolio and to address the social barriers that limit uptake.
The cultural dialogue brought health professionals and community stakeholders together in Tamavua, underlining the need for multisectoral discussion if the nation is to update its prevention strategies and reduce the impact of HIV going forward.
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