Ninety percent of funds allocated to Fiji’s HIV outbreak response have not reached frontline services, National HIV Outbreak and Cluster Response chair Dr Jason Mitchell has warned, as officials scramble to translate budgetary commitments into urgent on-the-ground care.
Of the $10 million set aside in the last financial year for the response, most — roughly $9 million — remains undelivered to the clinics, outreach programmes and commodities that patients and communities need now, Dr Mitchell said. He stressed the shortfall is not down to a lack of political will but to “slow systems” that cannot move at the pace required by a worsening epidemic.
“Because systems built for normal times cannot move at the speed this exploding epidemic demands,” Dr Mitchell said, listing staffing shortages, delayed approvals and procurement bottlenecks among the principal obstacles. He gave concrete examples: only 43 of the 167 positions identified as necessary for the scaled-up response have been filled; clinic leases are still awaiting approvals; several Cabinet memoranda remain in process; and procurement has stalled while essential commodities sit unordered.
The status of the workforce and supply chain has direct implications for service expansion, Dr Mitchell said. The Sexual and Reproductive Health (SRH) and HIV Unit, established by the health minister last June within the Ministry of Health, is attempting to build a network of clinics and outreach services “that has never existed at this scale before.” Nakasi Clinic in the Central Division was singled out as a central hub providing testing, treatment, counselling, harm reduction and community outreach in a stigma-free environment, but Dr Mitchell said those efforts need to be replicated and resourced nationwide.
Efforts to correct course are under way, he added. An outbreak response plan developed last year is being updated this month to incorporate lessons learned, and a comprehensive national strategy for HIV, sexually transmitted infections and bloodborne viruses is planned for later in the year as data and evidence are consolidated. Those strategic steps are intended to guide the prioritisation of staffing, procurement and clinic rollouts once the administrative and financial blockages are cleared.
Dr Mitchell’s assessment is the latest development in Fiji’s HIV response as health authorities move from emergency containment toward building a longer-term framework for prevention and care. The gap between budget allocation and service delivery highlights the challenge of converting pledged resources into timely action when routine government systems are stretched.
“We are working every day to change that,” Dr Mitchell said, urging acceleration of approvals and procurement to ensure that funds already allocated translate into tests, treatments, trained staff and harm-reduction services at the frontlines.
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