A Worldwide Gender Gap; Health remains the cruelest inequality of all, and the countries that could help sadly are not.

Byline: Kati Marton, Marton, author of "Hidden Power: Presidential Marriages That Shaped Our History" (Anchor), is chair of the International Women's Health Coalition.

Women suffer countless disadvantages compared with men. Even after decades of progress, we make up two thirds of the world's 880 million illiterate adults and up to 70 percent of its poorest citizens. But health remains the cruelest of all inequalities. In much of the world, women simply do not get equal medical attention. It is a fact with huge consequences for all of us. Maternal health translates into family health because healthy women are able to care for others--and family health is the foundation of any society's health. Experience shows that even small investments in women's health can pay large social dividends. Unfortunately, few of those who could make such investments are doing so.

The gender gap in health is especially dramatic in the HIV/AIDS epidemic. In sub-Saharan Africa, 60 percent of all AIDS victims are women. "It is a shocking fact," U.N. Secretary-General Kofi Annan said recently, "and one of which I, as an African man, feel ashamed, that a girl in some parts of sub-Saharan Africa is six times more likely to be affected than a boy." Polygamy, sexual coercion and violence against women all contribute to this shameful fact. Girls are frequently pressured into sex with older men in exchange for food, clothing or school tuition--or forced into it for nothing.

Abstinence and monogamy make for fine rhetoric, but they are inadequate defenses for women who are married off young and deprived of education and social status. In Zambia, only 11 percent of women in a recent survey thought a woman had the right to ask her husband to use a condom--even though women are twice as likely as men to contract HIV from a single sex act. In Senegal, at least half the women living with HIV/AIDS have no risk factor other than living in a monogamous union. In India, where 90 percent of female infections occur within marriage, women who stand up to their husbands risk violence--and those who get infected by their husbands are often shunned by their families. Lacking other skills, they may survive by selling sex--which, of course, spreads the disease further. Any real solution to the AIDS pandemic will have to empower women through education, information and a guarantee of rights.

AIDS is not the only threat women face. Consider the current state of reproductive health. An estimated 350 million couples want effective contraception but are unable to get it. The result: approximately 80 million unintended pregnancies each year, some 19 million of which are terminated under unsafe conditions. Those unsafe abortions cause 13 percent of the 600,000 deaths women suffer annually during childbirth. Wealthy nations could prevent this tragedy for a fraction of what they spend on the military. Thoraya Ahmed Obaid, director of the United Nations Population Fund, noted recently that one day's global military budget could "improve the lives of millions of women and families in developing countries."

Sadly, the current U.S. administration is not providing the leadership in this critical area. Driven by ideology, it has withheld its annual $34 million contribution to the U.N. Population Fund, the world's largest provider of family-planning services, since 2002. The Bush administration has also reimposed the so-called global gag rule, which effectively bars any organization that receives U.S. funds from discussing the full range of ...