And so if I can move on to my first question, this rise in the epidemic of HIV and Hep C, how is it affecting the people of Fiji?

We have many people who have been infected many years back but have not been on treatment and a lot of them are presenting with very complex opportunistic infections in which our clinicians are finding very difficult to manage because of limited resources and also lack of capacity to manage these very complex opportunistic infections.

One of the challenges we face is the absence of very strong surveillance data around the opportunistic infections that we're actually facing in our clinical services.

So it's difficult for me to talk about what these OIs might be.

But as you've highlighted, we have 59 cases of mother-to-child transmissions of HIV.

So it's obviously impacting our very young here in the country.

The year before, in 2024, we had 31 mother-to-child transmissions, and that's almost doubled in 2025.

So would you like to tell us how this sharp rise came about in 2024?

What are the stats telling you about injectable drug use?

Thank you, Jay.

You're right.

Drugs has always been in Fiji, but it's the type of drugs that have been introduced over the years, that's what's changed.

And the method in which we're injecting in the country, some of it is not unique to Fiji, but there are certain practices that are being practiced here in Fiji that makes it a more dangerous practice in terms of health.

A rapid assessment was conducted by researchers last year, in February last year.

And it's the only research, that formal research that has been done here, that is of good evidence.

What's your final comments?

I, I am, I'm more and more every day, the more work I do

doAround crime, um, and- and its impacts on health, like that would be the, the importance of both the two, two different sectors working together.

Like, I can't imagine, um, like just our learnings from COVID, um, the police were, you know, and, and other law enforcement agencies were very much part of the response 'cause they all had... we all had a n- a role to play.

But with regards to the drug situation and its impact on health, we're in completely different schools.

So because we're, we're having conversations about, um, legal protections for us as public health workers to introduce harm reduction, which includes needles and syringes, um, we're having to talk to people we would normally not need to talk to about public health interventions.

But we are asking for permission to do something which, in their view, is considered aiding and abetting in a crime.

And from our perspective as public health people, we see what we're trying to do as simply a public health intervention to prevent infections from, from occurring.

And just wondering from your experience, Jason, how might we, how might we go about that in the Pacific? If you were speaking at a regional forum on health, how would- what would you, what would you be saying right now from your position and your experience?

Mm-hmm.

And they tell you, "When you take this, um, and you put it with exercise, you have increased exercise capacity, um, you're likely to build muscle, uh, more rapidly, develop more strength, to be able to do more reps," um, that is all really accurate.

It's well-studied.

Um, when they say for healthy individuals that don't have medical illness or kidney problems, it's a safe supplement, it is a safe supplement.

That's been studied really, really well as well.

So I think in those categories, they're spot on.

Um, and it really becomes more of, you know, what physique do people want? Are they trying to push themselves on strength? And if those are things they want and, uh, they're otherwise healthy, it, it's a, it's a great supplement and you do get results from it.

Mitchell has the answer, so let's get into it.

medicine.What impact is it having on Fijian society, and what-- how are you seeing it manifest in health clinics, on the streets or in the communities?

All our clinicians are speaking of the large number of HIV-positive people who are presenting with opportunistic infections.

Some of them have AIDS, which is the late stage of HIV infections.

Many of them are, are succumbing from, from opportunistic infections and, and the-- and death rates are high, um, higher than they've ever been before.

We're certainly experiencing large groups of people who are living with HIV who are admitted in hospital for long periods of time.

Unfortunately, one of the challenges we face here in Fiji is the, the absence of strong data around what we're seeing on the ground.

So we don't have a, a good sense of how many admissions we're seeing in hospitals and how many of them are associated with HIV or opportunistic infections.

What's the impact on neighboring countries?