15 minutes with . . .
The doctor with seven billion patients
Authors: Guy Rughani
Publication date: 10 Aug 2011
Guy Rughani talks to Babatunde Osotimehin, executive director of the United Nations Population Fund
Name: Babatunde Osotimehin
Position: Executive director of the United Nations Population Fund (UNFPA) and an under secretary general of the United Nations.
Biography: Qualified from the University of Ibadan, Nigeria, in 1972 and achieved his doctorate in medicine in 1979 from the University of Birmingham, UK, specialising in clinical pathology. Became a fellow of the Royal College of Physicians of London and in 1990 was elected provost of the Ibadan College of Medicine. He was awarded the prestigious Officer of the Order of the Niger (OON) in 2005. As director general of the Nigerian National Agency for the Control of AIDS and then as Nigeria’s minister of health he led a period of steady decline in the country’s prevalence of HIV and AIDS. He was appointed executive director of the UNFPA in 2011.
What do you do at the UNFPA?
My job is an advocacy platform to ensure that we provide empowerment for people to be able to make choices in their reproductive health lives—particularly young people.
Feeding into that, we are the organisation that helps governments to conduct censuses so that they know what the population of their country is, enabling them to plan more effectively for future young people.
In northern Europe, where populations seem to be going down, there is concern about maintaining a reproductive base, with governments keen to promote pronatalist policies [encouraging reproduction].
In the global south [developing world] we have populations that are growing. We work with those governments to ensure that the growth of their populations does not outstrip the growth of their economies—so the people can maintain some sort of dignity.
We want to arrive at a point where women can have the number of children they want and can look after, and who they can educate and feed.
Do you find anything at the UNFPA frustrating?
My frustration is the inability to make things happen as quickly as I want them to. For example, 1000 women die every day giving birth. That is not acceptable. That is something we should be able to prevent because we know what to do. For as long as we cannot put in place the structures, programmes, and policies that are required to make sure that women have access to all they need, it will be frustrating.
What has been your most rewarding role?
The most rewarding has been working with the Nigerian government in an effort to control the HIV epidemic. When I started, the prevalence was at almost 6%, and when I left it had dropped to about 4%. And beyond just reducing the prevalence, we had gone from zero to about 300 000 people on treatment. For me, that was something that I could be happy about.
Going forward, we need to deepen our efforts at prevention and ensure that we don’t get new infections in young people and also ensure that those who require treatment can access treatment. We’ve had lots of programmes that address HIV, but we need to integrate those into a larger context of primary care that provides not just for HIV but also for maternal care, antenatal care, child immunisation, and other things. That standard package of care would deal with more things and would be more cost efficient in, for example, human resources. I think this integration is beginning to happen.
Did you always want to do medicine?
Always. I don’t think I ever had an option B. From the day I knew what it was to be a professional, I always wanted to be a doctor. My father was a teacher, and my mother was a teacher, so it wasn’t because there was some inspiration in the family. I just wanted to be a doctor. The most memorable day of my life was that transformation from being Mr Osotimehin to Dr Osotimehin. I was very young, so I was standing there asking myself, “Oh my goodness, so this has happened now?” It was quite momentous for me.
When you started out did you have any ambition to work on a global scale?
No. All I wanted to do was be a good doctor. As things turned out, opportunities came along and I just grabbed them.
How would you advise doctors with ambitions to work for the UN?
As a doctor, you should want to be a doctor first. Then perhaps do some public health tuition and work in other parts of the world, because that’s what builds you up to be able to appreciate globally what the challenges are before you get to the UN. If you go to the UN as a British doctor, you are very narrow and you don’t know much about what’s going on elsewhere.
What is the best bit of advice you have ever been given?
It was given by Sir Raymond Hoffenberg, who later became president of the Royal College of Physicians. I’d finished membership in medicine and did an MD in Birmingham. I wanted to stay and practise in England. He said, “No, you should go back to Nigeria,” and I think that was very good advice. What he told me then holds true today. You will probably help 10 000 or a 100 000 people in this country running a specialist clinic. But think about it—you are going to touch the lives of millions of people if you go back to Nigeria.
From the Student BMJ.
Guy Rughani Clegg scholar, BMJ