Doctor, lawyer, accountant, or engineer. Those were the career options Fadekemi Akinfaderin-Agarau was presented with early in life. Heading up a youth health nonprofit was not on the list.

Akinfaderin-Agarau is the founder of Education as a Vaccine (EVA), a nonprofit organization based in Abuja, Nigeria, that works to advance young Nigerians’ sexual health and rights through local, national, and international advocacy and peer-to-peer education campaigns. The need for EVA’s work couldn’t be greater: Young people ages 18-24 account for nearly one-third of Nigeria’s total population, and yet they are among the most underserved. A lack of knowledge about their bodies, sex, and reproductive health has led to staggering rates of unwanted pregnancies that lead to unsafe abortions, and the second-highest rates of HIV/AIDS in the world.

But working to advance young people’s sexual health and rights wasn’t on the agenda when she moved to New York at 13 with her father, three sisters and two brothers. In fact, she was already on the path to becoming a doctor. “You can’t have Nigerian parents without having a particular profession sort of picked out for you,” Akinfaderin-Agarau says. “Mine was doctor, so everything I did was geared towards that.”

As a pre-med student at Wesleyan University in 1998, Akinfaderin-Agarau double-majored in biochemistry and organic chemistry.  When she was in her junior year, one professor invited her to participate in a National Institute of Health (NIH) fellowship in Umtata, a small community on the eastern cape of South Africa, to study the particular strains of HIV found there.

Her experience in South Africa changed her life. “It was the worst but most significant four months of my life. I was responsible for getting blood samples from a general hospital’s maternity clinic and bringing it back and testing it, because it was only HIV-positive samples we can do our research on. When I’d come back with 10 blood samples and eight were HIV-positive, everyone would be really excited.”

But Akinfaderin-Agarau was devastated. She never knew what happened to the women whose blood she took. Did they know they were HIV-positive? Would they be treated? “We had no interactions with these people. That really bothered me,” she says.

The experience spurred her to do something beyond returning to the U.S. and going to med school. “I wanted to see what was happening in Nigeria and West Africa as a whole. So I did some research and saw [the HIV/AIDS epidemic] was just as bad in Nigeria.” With the help from three classmates, Akinfaderin-Agarau submitted a proposal to the Echoing Green foundation for a fellowship to create community and school-based programs that would empower young Nigerians to educate their peers about HIV/AIDS, sexuality, and contraception.  “We wanted young people to be part of the solution,” she says. The two-year fellowship enabled Akinfaderin-Agarau and her fellow pre-med classmate, Lola Adebiyi, to establish EVA in Abuja.

Establishing an office in Abuja was a challenge of its own. “We had no electricity for most of the time,” she says. “Internet was available but we didn’t have it in our office, so we would have to go out to cyber cafés.  Phones were super-expensive, so we had to line up to use a public phone.” A far cry from the computer centers with laptops and cell phones they were accustomed to at Wesleyan.

EVA’s early programming centered on month-long engagements at secondary schools where Akinfaderin-Agarau and Adebiyi taught a reproductive health education curriculum two or three times a week. The reaction from parents was almost always positive, and the duo learned of one unexpected outcome: their sexuality education lessons were prompting conversations between parents and their children that might otherwise not have happened.

Word of mouth about EVA’s program spread. “Eventually the Ministry of Education asked to have a meeting with us. They gave us approval to work in all 30 secondary schools in Abuja.  We were struggling to get into schools before, and then all of a sudden, everyone wanted us to come and do this work in schools.” Many students would seek out “Auntie Kemi” and “Auntie Lola” at their homes and office to speak with them, asking questions and confiding in them. “We had loads of students who were pregnant.  Loads—which was disheartening. People had syphilis; luckily we never had anyone that was HIV-positive,” Akinfaderin-Agarau recalls. In one particularly troubling case, Akinfaderin-Agarau learned one teacher was sexually exploiting his students by trading sex for grades. “We got that teacher fired,” she says.

EVA’s program continued for three years, until 2001, when the federal government adopted the National Sexuality Education Curriculum. EVA then shifted its mission to providing services and education outside schools, at the community level. In 2002, Akinfaderin-Agarau returned to New York to study public health at Columbia University. After receiving her master’s degree, she returned to Nigeria.

Today, Akinfaderin-Agarau is still at the helm of EVA, and continues to work multiple fronts to secure young people’s access to sexual and reproductive health services and information. EVA continues to serve the youth population through many programs including its My Question & Answer program, where questions related to reproductive health, sexuality and related issues are answered within 24 hours through a toll-free hotline, SMS, and Facebook chat.

EVA is also working with young people to influence policy at the local and national levels; their Youth Advocates Group (YAG) actively lobbied for the inclusion of services for young people in the National Health Bill, which passed the Senate in February. The YAG successfully advocated for the passage of the HIV/AIDS Anti-Stigma Bill, which contains a provision that would end mandatory HIV tests for students applying to schools. The Anti-Stigma Bill passed the Senate on April 10, 2014; it now awaits reconciliation with version of the bill passed by the National Assembly before it’s sent to President Goodluck Jonathan for his signature.

Akinfaderin-Agarau’s shift from helping individual students and youth to possibly all young Nigerians is a natural fit. “When you work with one person, you are making a change in that person’s life. But when you change policy, you are creating a ripple effect,” she says. — Suzanne Ito