Swaziland and Lesotho, with a prevalence rate of 25 percent, are the African countries most struck by the spread of the virus despite frantic efforts by their governments to deal with it, Stephen Lewis, the UN special envoy for HIV/AIDS in Africa, said Friday.
"The mind fractures at the thought of it," said Lewis, who is known for unsparing assessments of the powerful and the UN.
Lesotho is confronted with a "deluge of orphans", he said. By 2010, 10 to 15 percent of the entire population will consist of orphans. Lewis said last month he visited a primary school with 350 students in Lesotho, 250 of whom are orphans.
Swaziland is ruled by a polygamist king who has been criticised, including by Lewis, for failing to rally the country against AIDS.
Lewis said he had a rare one-on-one interview with the king last month to discuss the spreading disease and they talked about every controversial issue. He refused to give details.
Lewis said Jim Kim, a WHO doctor, confirmed this week that the HIV prevalence rate for young girls - 15 to 17 - in Lesotho stood roughly at 30 percent. HIV prevalence for pregnant women in Swaziland stood at 56.3 percent.
He said it would take those two countries a "gargantuan uphill struggle" to reverse the disease.
"It is impossible to visit countries like Lesotho and Swaziland, without an enveloping sense of horror and despair at the carnage among women," Lewis said.
"And in very large part, this carnage took root and has been allowed to rage because the voice of women is the voice that is still not heard."
"I have to say that the United Nations doesn't seem to understand this truth," Lewis said.
He said African women and girls remain vulnerable to rape and sexual violence, marital rape, early marriage to older men, polygamy, female genital mutilation, illiteracy and lack of education, lack of representation in parliaments and lack of right to own and inherit land or property.
"The litany never ends," he said.
He criticised the effectiveness of UN groups that fight for women's rights, suggesting that their efforts should be combined and then "enhanced a hundredfold".
Lewis, a former Canadian diplomat, had accused the world's richest countries of not doing enough to fight HIV/AIDS.