Young people now make up over a quarter of the world's population, mostly in Africa and south Asia. “They are the ones who are going to determine the next wave of population and the ones who will have to make their choices in their lives”, he says. As adults, Osotimehin says, “too often we imagine that we know what young people need”, but what is important is “our ability to listen and experience, to learn about our children, our ability to allow them their space”. The participation of young people will be his special focus at UNFPA. Sworn in last month, he is calling on UNFPA's officers, partners, and UN member states to embody a vision of young women and men empowered to voluntarily make responsible reproductive decisions, with services available to all to plan pregnancy and reduce maternal mortality. “Working together” is the way to make progress, Osotimehin says. “We need to ensure that young people of both genders have equal participation, not only in reproductive rights and health but also within society and in the economy.”

Having spent most of his working life in Nigeria, Africa's most populous nation and home to a huge diversity of cultures and contexts, Osotimehin knows that UNFPA needs to ensure adequate representation, with voices from different perspectives, to develop solutions. “Osotimehin consistently engages civil society and is a champion for adolescent health and human rights”, says Adrienne Germain, President of the International Women's Health Coalition. Germain recalls how when he was Chairman of Nigeria's National Action Committee on AIDS (NACA), from 2002 to 2007, Osotimehin spoke up for young women, writing that: “In Nigeria, we are painfully aware that girls and women typically cannot negotiate when, where, or with whom they have sex; that far too few have access to affordable health services; and that sex education is not available or accessible to many girls.”

Osotimehin's willingness to engage with many different groups in civil society, especially young people and women, was a key reason for his success as Chairman and later Director General of NACA, which was renamed the Nigerian National Agency for the Control of HIV/AIDS. He also worked with the predominant religious groups in the country—Christians and Muslims—to take a common position on HIV/AIDS. At the same time, he was critical of abstinence-only programmes and publicly promoted the need for HIV testing. These and other actions helped transform awareness of the disease and stabilised the HIV/AIDS epidemic in Nigeria, says Adetunbo Lucas, who was professor of public health at the University of Ibadan, Nigeria, when Osotimehin was a medical student there until 1972. Lucas has followed Osotimehin's career for over 40 years, from academic and professional success in the field of reproductive health through to increasingly senior management positions in public health.

When HIV prevalence started to fall in Nigeria, Osotimehin says he “felt very humbled”. Although people from the outside might think of Nigeria as a challenging country, he says, “by starting from nothing we were able to do some very creative things, such as building NACA and its collaborations”—today NACA has systems in place that manage more than US$1 billion. Subsequently, as Minister of Health for Nigeria, Osotimehin brought all 36 states together to build a national health plan focused on primary health care. When asked, in 2008, by the then President of Nigeria to tackle his country's wild poliovirus epidemic, Osotimehin says that involving local community leaders was instrumental in solving the problem of low immunisation uptake: “They took it as a challenge and said ‘leave it with us’. They organised the immunisation dates, selected the community mobilisers who ensured awareness and high attendance in their communities. In 1 year, the prevalence of wild poliovirus fell by 90%”, he explains.

Osotimehin now brings “his exceptional intellect and leadership capacity” to UNFPA, says Germain. A softly spoken man with a ready smile who is “an inspiration to students and colleagues”, according to Lucas, Osotimehin wanted to be a doctor for as long as he can remember. He recognises the privilege of this role, and he urges young doctors “to be humble and give back to society more than what we have been given”. Humility, says Osotimehin, is the key to engagement—“humility to engage with the other person or the other community in such a way that they know that you respect them”. So greater understanding by UNFPA of the context and sensitivities of cultures and communities and the importance of different players is vital. “Most of the time we go in as if we know it all, but we are only human and often we don't”, he says. At UNFPA, the mark of substance will be the ability to engage civil society at the grassroots level, says Osotimehin, “because that is where things are going to happen. They won't happen in New York”.