At present, no UN agency is dedicated exclusively to women's human rights and development needs. A set of under-resourced entities are expected to address the concerns of half the world's population.

Earlier this month, Lewis pressed for change before a high-level panel on UN reform in Geneva. He proposed the creation of an independent multilateral agency with the stature and resources necessary to meaningfully improve the lives of women.

Lewis's urgency for UN reform is driven, in large part, by the international community's disregard for the devastating and disproportionate effects of HIV/AIDS on women and girls.

As of 2005, 17.5 million women were living with HIV, out of a total of 36 million adult sufferers. In southern Africa, 57 per cent of people with AIDS are women. Infection rates among adolescent girls and young women worldwide are shockingly higher than those of their male counterparts.

Some women's advocacy groups and UN insiders remain skeptical. They fear that the creation of a separate agency may marginalize women's issues. Efforts should focus on improving gender mainstreaming, they believe.

Yet Lewis and others are skeptical of this approach, noting its failure thus far to secure women's access to education, health care, and property rights, among others.

What institutional structure will work best is difficult to answer, but this we know: There is a dire need for change. International co-operative efforts for gender equality are failing, resulting in catastrophic loss of life.

While women are at least twice as likely as men to be infected with HIV during sexual intercourse, biology alone cannot explain the growing numbers of infected women and girls.

Women's inequality — their legal, political, social and economic subordination — renders them most vulnerable. Gender-based violence and coerced sex, lack of sexual health education and access to prevention and treatment services and abject poverty underscore women's vulnerability.

If HIV/AIDS policies are to be effective, they must address the realities of women's lives. In many parts of southern Africa, married women are at a greater risk of contracting HIV than sexually active, single women.

In rural Uganda, 88 per cent of young women living with HIV are married. In Cambodia, 42 per cent of all new HIV infections occur from transmission by husbands to wives. Married women often cannot negotiate safer sex, refuse sex, insist on partner fidelity, or leave high-risk relationships for fear of physical abuse or economic deprivation.

Coercion also characterizes many girls' sexual experiences. In South Africa, 30 per cent of women's first instance of intercourse is forced and 71 per cent experience sex against their will at some point during their lives. Required to care and support families affected by HIV/AIDS, many young girls have few alternatives to high-risk prostitution to support themselves and their dependants.

Prevention strategies that emphasize abstinence ignore embedded patriarchal norms that promote male sexual privilege.

The situation is further complicated by the denial of rights to privacy, informed consent and non-discrimination in access to testing and treatment.

In Latin America and the Caribbean, women are increasingly subject to HIV testing without their consent.

Many women avoid testing and treatment services for fear of disclosure and the subsequent blame, abuse and ostracism that follows.

Studies in India indicate that HIV-positive women infected by their husbands are often blamed for their husbands' illnesses.

In many parts of Africa, surviving widows and orphans are not only stigmatized, but regularly abandoned by family and evicted from their homes under discriminatory inheritance laws and customs.

In a positive development, antiretroviral (ARV) drugs can reduce the risk of mother-to-child transmission among the 2.2 million HIV-positive women who give birth each year.

In the developed world, newborn infection rates have been virtually eliminated. The same is far from true in developing countries where fewer than 10 per cent of pregnant, HIV-positive women receive ARV therapy.

While women may be able to access therapy, fears of domestic violence upon disclosure of their status or the forced sharing of medication with partners may prohibit their continued and consistent use of such drugs.

Women's survival requires that HIV/AIDS policies and programs address women's distinct and diverse needs and circumstances.

The UN's failure to dedicate the necessary resources to ensure women's systemic equality indicates more than neglect or indifference. It sends a powerful message that women are not worthy of expenditure. It implies that women's lives are not as valuable as the lives of others.

Next month, the University of Toronto's Faculty of Law will host a workshop on "Women, HIV/AIDS and Human Rights" at the 16th International AIDS Conference in Toronto. We seek an equality that is real, that allows women to participate as respected and valued members of a world community. It is our basic human right.

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Joanna Erdman co-directs the International Program on Reproductive and Sexual Health Law at the University of Toronto, Faculty of Law. Lisa Kelly graduated from the faculty this spring and is articling in Ottawa.