or greetings to each and every one of you from uh wherever you uh hailed from and you sail through to be here with us in Fiji. Once again, the introduction was made by the honorable minister for health who happens to be my son as well. He was finding it difficult [clears throat] to say whatever you wanted to say was understandably it's quite difficult. and our development partners, representatives of the Pacific governments, health ministries, law enforcements, agencies, universities and research institutions, our frontline clinicians, nurses, laboratory teams, peer workers and community organizations and advocates, people living with HIV, their families and commitments communities, distinguished delegates, ladies and gentlemen, in my dialect Nishambula Vina And a very warm welcome to you all. Once again, a special welcome to those of you who travel from abroad to join us today for this very important event. It is indeed a great honor and privilege both for me and my wife to join you this morning and to welcome you to and formally open the inaugural Pacific HIV symposium for 2026. Ladies and gentlemen, before I continue, I also like to acknowledge at this point with respect the ancestral owners of this land that we've carried on here this morning, especially the moleu chief of Nandi Turandi and the Turana of Natu that has already been highlighted by the madame MC. I would like to take this opportunity to acknowledge and commend the Australian Australasian Society for HIV medicines and the symposium conveners working with Fiji's Ministry of Health and Medical Services, the Papu Guini National Department of Health, the Fiji National University, community organizations, technical agencies, technical agencies and develop partners for bringing us together around the theme that is exactly right for this moment equipping the front line regional and action and cross country learning. It's quite a big gathering ladies and gentlemen. Yes, I can recall one of my predecessors was a very strong advocate for this. Our former late president wherever you went he would be preaching something about HIV and AIDS. So I one of the challenges challenges he used to challenge us with is put it on bring it on. I'd like to echo that because it's uh but that speaks volumes of where we are how this is affecting our communities. No matter how hard we try, let the turn of bli to the family. It's the family that's the most important part of this scourge. Especially in the Pacific, we now have these problems of drugs. I was in the UK last year. with my wife having a tour being able to meet with his Majesty King Charles and had an opportunity to meet with the United Kingdom's military. I would say in the hope of engaging the UK military in her best we can take care of our drug problems, especially for us in the Pacific because when that problem arrived on our shores, we were not prepared. Every year we have the nationals for athletics. and well as and as well as rugby big tournament like Australia and New Zealand bit rugby crazy as well and for Samo and Tonga and Papu Guini but what happened during the mass introduction of drugs within this side of the And as I said a while ago, we were not prepared and we were looking at our own children doing the things that we now have come here together to try and address. We using of strangers need one takes a dose of blood. And then they use the syringe to take out the blood from them and they inject it in themselves and I don't know whether it was a shortage of drugs or the maximization of the usage of drugs. Then all of a sudden another six took it to themselves to be injected with this uh way of uh transplanting the effects of drugs to the six that were there or the eight or the 10 and all of a sudden now drug problems hit the roof. You were not prepared, but it has arrived. And uh ladies and gentlemen, I would like to take this opportunity to acknowledge and commend the Australasian Society for HIV Medicine and the symposium conveners. I've said this and I want to repeat it again. Papi, New Guinea National Development of Department of Health, Fiji University, community organizations, especially coming together to address the theme equipping the front line of regional action and crosscountry learning. I've started by highlighting the problems that we have here. Data doesn't lie. It ranks Fiji second in the Pacific. No matter how hard we try, but we have a master, a big problem. So ladies and gentlemen, this is not simply a medical conference. It is a meeting about human lives. It is about dignity. It is about the strength of our health systems, the resilience of our community, the security of our region, and most importantly, ladies and gentlemen, it's the future of our blue Pacific. And because HIV deals with people, our response, ladies and gentlemen, must always begin with people. Before we talk about the systems or statistics, we should remember what every number represents. A diagnosis belongs to a person who may be frightened about the future. A misappointment may reflect transport cost, fear of discrimination, family pressure or difficulty reaching a service. A child living with HIV represents a family. He didn't care. information and most importantly support. You can't really forget or push aside your family if they are in trouble. You must help a learning hand. Try and help them. Our task therefore is not simply to control the virus. It is to create conditions in which people can protect themselves, know their status, receive treatment early, remain in care, and live healthy and productive lives without fear or shame. Ladies and gentlemen, Fiji's latest national surveillance data should command our full attention. In 2025, Fiji recorded 2016 diagnosis or diagnosed HIV cases, the highest annual number in our national survey. That was about 27%. higher than the 1,583 diagnosis recorded in 2024 and we must interpret those figures very very carefully. A diagnosis recorded in a year is not always an infection acquired in that year. This is where data plays a very important role here. Expanded testing is finding previously undiagnosed undiagnosed people which is an important progress as we have all these facilities to make diagnosis etc. test some still fall in those cracks in those gaps. and we avoid be testing what the figure that I've just highlighted can be much much more this is just like it's the tip of the iceberg of the numbers but the national evidence also points to ongoing and rapidly increasing transmission We therefore have no basis for complacency. The age profile especially a major concern is a major concern. In 2025, people age between 20 and 24 accounted for 646 diagnosis. Almost one in every three. Our population hasn't reached 1 million yet. This one is strangling us right in the throat. And for the 646, most of them are young Fijians entering the adulthood starting careers. forming relationships and families and caring our country's future. When an epidemic becomes concentrated amongst young people, the consequences are not limited to the health sector. This is what I was just alluding to a while ago. the they affect families, productivity, education, social stability, and national development. Ladies and gentlemen, this is not a new thing to the Pacific region because we've had problems such as existing in the past. Our bodies were not prepared for the onslaught of uh epidemic, onslaught of mis age of our coming into being as a colonial part of the world. We suffered a lot. Our population were reduced drastically. you from the it's along the Pacific region from the Polynesian countries right down to Melanesian and Fiji got in between Malaysian and Polynesian existing together and we had a drastic reduction in our population and then with the ongoing of education development world that we are part of help from neighboring countries Australia New Zealand we able to stand again on our feet and take a step forward population start building is starting to build up again but now we're faced with this The figures for children, ladies and gentlemen, demand a nuclear serious response. 67 children under 15 were diagnosed in 2025. You you may hear me pronouncing the years 2024, 2025. This is only just a couple of years ago. So 15 children were diagnosed in 2025 including 56 cases attributed to mother to child transmission. 17 HIV related deaths were reported amongst children aged zero to 14. Every preventable infection in a child must challenge us to examine the full chain of antal testing, maternal treatment, safe delivery, infant diagnosis, followup and family support. Times are changing. Ladies and gentlemen, we in the Pacific, our way of living needs to be relooked to relooked in depth. Our culture and traditions and tradition tends to dictate a lot in how we live. Women are left on the sideline to tend to the children whether they are fit or healthy or sick. It's for the mothers to take care of that with these eggs symposium. Ladies and gentlemen, I might uh just add here some of the experience that I've come across with Raet, our former late president when he's a champion for HIV and AIDS fighting against it. He started introducing ladies that were infected. They have the strength and the courage to come and share the experience with us. First of all, it's a strange thing to happen when you started inviting women who in fact come and share the experience and all of a sudden we saw pictures of Lady Diana holding babies, young kids very close to them who were affected. That's the quickest way you educate people, ladies and gentlemen. [snorts] You may come up with a fantastic papers here, but fantastic ideas as well, but the best way is try and spearhead. The way we spread the good news about this is to encourage them to come forward and share their experiences with us. Some of the ladies, I think none of them are here. They shared their stories. It was quite touching. Very young. And they've been affected by this sickness. they couldn't have any more children. Some of that. So all of a sudden we saw in front of us in that meeting some living people walking around that been affected by this sickness. And that brings me to one of the most important policy changes challenges before us is the HIV care. Now that cascades at the end of uh 2025, Fiji's national systems recorded 3,535 people living with HIV. That's a huge number, ladies and gentlemen, with 1,979 receiving anti- retroviral therapy. Among people newly diagnosed during 2025, more than four in 10 were recorded as not yet enrolled in care. The report also identifies important gaps in viral load monitoring and documented suppression. As we engage ourselves in this [clears throat] important task to try to try and alleviate hopefully radicate but we me must be mindful if we take another step forward please just look around how do we get people to positively contribute to of the dangers of this sickness that is already affecting them. Here again in the Pacific the confidentiality of this is quite important. We as extended families we live in communities. Everything we own we share. when it comes to this uh HIV problem if we do not know that is a terrible disease then it's going to affect the whole village in a very short in a very short time that is available to Fiji as I said earlier we are plagued with this problem of drugs coming in and how they use stringers and all and that saw the rise in the number of HIV that we've got. We don't really have a rehabilitation center for drug addicts. That's it. for HIV just recently passed in parliament. We've now allocated a huge sum of 10 million Fijian to look and fund ideas to properly try and reduce this butin learning a lot. We're learning a lot how they've been tackling this. They are our neighbor. They're filled with huge resources. They're well off so to speak. But at the same time, it's a new phenomenon that has come upon them. This plague into our neighboring even to our neighboring countries because our culture is a one of merry making and happiness. It's either you see them merry making with dances etc or they are silent with acknowledging that one has passed on. Those are the two sides of our lives in the Pacific. Now where agony comes in and the prolonging of agony with this kind of sickness HIV, it's a new frontier for us. We doing all our best to address this. And I I'd like to take this moment and acknowledge moment and acknowledge the frontline workers, the health workers, the volunteers. See, countries that devote a lot to how best we can reduce and curb this devastating illness. You go, you walk with them, you sit and talk with the patients, the people that are suffering from the sickness, and you continue to enjoy life by saving people that are in need. We're almost nearing another new J election in Fiji. Governments present in the past will look only at track records. What have they done for the poor and the needy? But it's meetings such as this as symposium such as these are very important. If only we could hear each other. If only the heads of the various agencies that are represented here, please just hear the people out from developing countries. [snorts] It's like the phenomenon of weather, climate change. All of a sudden you see plates floating and everything. Then you realize, oh, this is affecting us. >> [snorts] >> But with this one here, HIV, if you're not careful, village will become extinct. If you're not careful, antiretroviral is an important med medicine for us for the people that are affected. But the accessibility to that medicine, that's another question. How we protect the information regarding those that have been affected because you know our culture doesn't allow us to do that. Our culture encourage us to most almost say anything about you or your neighbor your members of your family even if they are sick you'll be just saying oh yes yes yes one of my family members is sick there I don't know what sort of sickness is suffering have they taken time and care to go and visit them that's another Ladies and gentlemen, one of the lessons that we've learned from all that is happening given the numbers that are going highlighting the bottom line is we need to make the path from testing to treatment shorter. faster, easier and simple. Full stop. That's all. The longer you take, the longer you take to go to the lab, the longer you take to get back, that patient has disappeared. And that patient has taken with them this dreadful sickness. No one should stop treating because medicine are difficult to obtain. Confidentiality is uncertain. Transport is unaffordable or are not affordable or services are not designed around the realities of people's lives. We must strengthen rapid treatment, initiation, reliable medicine supply, decentralized services, viral load testing, patient tracking and re-engagement in care. These operational details can make the difference between a diagnosis that creates fear and one that becomes the very starting point for a long and healthy life. Ladies and gentlemen, we must communicate. We also communicate the science clearly. The person living with HIV is on effective treatment maintains an undetectable viral load does not sexually transmit HIV. Again, this has this brings us to what we mean by you equals U. Undetectable equals untransmittable. So therefore you equals you. It's not only scientific fact. It's a message of hope, a reason to test, a reason to begin treatment early and one of the strongest tools we have to challenge the stigma. Prevention must match the reality of transmission. We cannot treat our way out of an expanding epidemic. Prevention must be strengthened at the same time as treatment. Fiji's epidemic is driven through more than one pathway. Sexual transmission remains important while unsafe injecting and drug of drug use. that has emerged is a major driver of transmission amongst uh some populations who WH reported and among people starting HIV treatment in Fiji in 2024 48% for people who inject drugs into themselves. This tells us that the preventant policy prevent prevention policy must match the actual uh pattern of transmission not the pattern you may wish existed. We want to control the issuance of strangers. We start making laws. But again in this poverty you're just issuing the very things that we're trying to protect from the people a free license to operate and the reduction and the the way they can enjoy life as a developing country Fiji. Our prevention toolkit must therefore be comprehensive. Accurate sexual and reproductive health information. Condoms appropriate access to PR and PEP. regular testing, prevention and treatment of sexually transmitted informations, community-led outreach and services designed with young people and key populations. That brings me to another interesting uh development that I will try and share. You know as a traditional leader we've been given this challenge by the people by the media. What's your position or what's your stance on this as a traditional leader by involving young ones to self inject them and then landly spreading this with the use of stringers. One of the first ways that we've uh kind of tried to address that is oh well if you're taking drugs mathematine or whatever you are now being asked to leave the village but is it the best way that young fellow a boy or a girl lady or gentleman belongs to that village. [snorts] But he succumbed to this kind of succumb to the attractiveness of uh the usage of drugs. Now they suffering but when they suffer through the expulsion from the village I don't know and all of a sudden you see the immediate family it'll be missing from the village maybe they tending to their relatives who have moved on to the urban centers trying to access whatever way they could be helped. in uh curbing this disease but there is at the same time they lost touch with their families for us in the Pacific family are very important not only for the Pacific the whole world that's your co center when we gather we gather a We come together collectively to try and address issues. But when it comes to HIV, the late former president of Fiji was the individual fighting alone in his attempt to be a strong advocate on this fight against HIV. Henry, [snorts] the response to the whole of government and the whole of society. Earlier this year the ignoral ignoral uh inaugural Pacific policy ministries police ministers meeting helier in Fiji minister supported stronger harm reduction approaches according to national context and close cooperation between police health and social services. We also supported the development of uh harm reduction protocols while keeping enforcement focused on criminal syndicates and trafficking networks. Ladies and gentlemen, HIV cannot be left to ministries of health alone. education, social welfare, police and justice, finance, local government, youth organizations, employers, faith communities, traditional leaders, it may everybody in society, all shape, wherever prevention is understood, services are trusted and programs are sustained everyone. And that's the message I would like to share this morning. You've come in numbers and we really appreciate it. But the fact from our front lines, from the health workers, for the volunteers, Fiji, the numbers has continued to climb, continued to increase. And can we turn a blind eye to this and say, "Oh, let's continue with our preparation for the next election. Let's try and improve tourism because all this will knuckle down to this country with very little control over it. uh from information shared from people that have been affected. They are continuing to enjoy life. It's closer care and medicine. That's the way to go. Ladies and gentlemen, I'd like to test you, but it'll go on and on and on. Yeah, you're all familiar with this topic, HIV and AIDS. What's the best you are, but I leave it entirely up to you. In your deliberations for these next few days, there are more concrete answers will surface from this meeting as the best way forward for us [snorts] to address these problems. I'd like to add also that communities must be partners and not an afterthought. These imposing programs rightly places community leadership throughout the agenda in preventing testing monitoring treatment adherence and human rights, human rights and harm reduction. A clinic, ladies and gentlemen, may have medicines, but a peer worker may give someone the confidence to walk through the door and share the experience of how this sickness is affecting them. And if you're not careful, this very thing that each government is trying to push ahead to see that the economy improves every time. This one would be on the opposite end because it's the people that are suffering. Now we have this target for 2030 global commitment and the Pacific responsibility. That's one that has been agreed to in the United Nations and we set the timeline 2030. Maybe those are some of the issues that you'll be addressing. The deadline of 2030 is now very close for countries with falling infections. The challenge is to protect gains for Fiji, Papu Guini and other places where infections are rising. The challenge is more immediate. We must bend the curve while building systems that can sustain the response for the long term. So we begin this inaugural Pacific HIV symposium. I mean as we begin this I would respectfully propose that our deliberations be guided by seven practical commitments. First, we put prevention back at the center using the full combination of uh biomed, behavioral and community-led approaches including evidence-based arm reduction. The second make testing routine accessible, confidential and close to the people and ensure every positive diagnosis is linked rapidly to treatment. Third, strengthen the retention in care, medicine security, viral order monitoring and the public understanding of what you equals you is all about. So that treatment becomes both a lifesaving intervention and a prevention strategy. Fourth, make the elimination of mother to child transmission a regional priority with particular attention to an antiatal assistance, infants, children and even adolescence. First, confront stigma and discrimination as public health barriers. not as secondary social concerns protect confidentiality, human and equitable access to services. Six, institutionalized community leadership. give people living with HIV, HIV, peer and peer organizations affected and communities a formal role in designing, delivering and evaluating the responses. Ladies and gentlemen, in concluding delegates, the program before you program before you is ambitious. It addresses preventing, prevention, testing, the elimination of vertical transmission, enabling environments and human rights, mental health and well-being, co-infection, drug use and harm reduction, treatment access and adolescence, pediatric and adolescence care, culture confidentiality and community leadership. These are not separate problems ladies and gentlemen. We are different parts of one human journey. The journey from risk to prevention, from uncertainty to testing, from diagnosis to treatment, and from treatment to viral supply for suppression, and from fear to stigma and hope. To the people living with HIV, you're not a problem to be solved. You are partners and leaders in the solution. Your experience must help guide our policies and services to our health workers, peer workers, researchers, police partners, volunteers, community advocates right out there in the front line. I see a big winner to you all in the work. that is essential to the health of our nation to the west society of HIV medicine Fiji's Ministry of Health and Medical Services Guinea Department of Health, Fiji National University, the United Nations family, development partners and every organization that has made this gathering possible. Fiji. Thank you. So, may this first specific HIV symposium mark a turning point rising diagnosis to full colon transmissions from late diagnosis to early care. from preventable infection in children to HIV free start in life. From fragmented services to a connected continuum of care, from stigma to dignity and from isolated national response to a stronger coordinated Pacific movement. The ocean that surrounds us connect our people and carries our knowledge. Let us now let it now carry a new determination across the region. So every person on every island deserves prevention, testing, treatment and care without fear and without shame. Let us equip ourselves. Let us equip the front line. Let us learn from one another and above all let us act with urgency as this moment demands. With those few words, it is my great privilege to declare the inaugural inaugural Pacific HIV symposium 2026 officially open and thank you very much for your attention.