Update: Almost seven months after Obama announced a stepped-up civilian effort to bolster troops in Afghanistan, many civil institutions are deteriorating as much as the country's security, the New York Times reports today. System of delivering aid is "broken."

President Obama's Nobel Peace Prize?

Yes, we can celebrate it, but "we must continue to hold the President accountable so that he can, in fact, deliver on the promise of peace," says Kavita Ramdas, CEO of the Global Fund for Women.

But holding him accountable may also mean changing our ideas of what peace and security actually mean.

In Afghanistan, possibly the least peaceful or secure place on earth, it's time for Obama to shift the balance of U.S. troops from soldiers to armies of doctors, midwives, engineers and arborists, Ramdas said, addressing the University of Washington School of Global Health earlier this week.

"Stop feeding the beast," she said. "We have too many guns and way too little butter."

Fortifying militaries might make the public feel safer, but it is eroding the actual security and well being of the world's women, she said.

Ramdas made an argument I am hearing more frequently these days: that the world's security is connected to the welfare of women, especially in developing countries.

Their physical safety diminishes in militarized settings like Afghanistan, Colombia, the Democratic Republic of Congo, Gaza and even within the U.S., she said.

"When militarism combines with the ideology of patriarchy, which accords women intrinsically lower value than men, it results in what most of the world faces today -- stunningly high levels of violence against women in every part of the globe," she said. "The scale of this violence is truly at the level of an epidemic."

Ramdas grew up in a privileged family in New Delhi -- her father is the former head of the Indian navy, turned peace activist. She runs the largest non-profit organization in the world dedicated exclusively to international women's rights. Ramdas is also one of the more outspoken members of the Gates Foundation's program advisory panels.

Almost everywhere, a large presence of troops correlates with high incidences of rape, prostitution, domestic violence and other problems, she said. "Survival sex" is common -- organizations working in such situations report that girls are often resorting to sex for food.

Conversely, where women's health and education is improved, and more females enter the workforce, countries achieve rapid reductions in poverty.

In Afghanistan, an infusion of new troops was supposed to secure control and help pave the way for more "soft power" efforts. But some influential aid groups, including World Vision, have argued that the U.S. should pay more attention to economic development, and separate that work from its military operations.

Ramdas poses a more fundamental question: "If the strategies that we used up to this point have not succeeded in ensuring the safety and well being of women and girls, what makes us think that increased militarization with 30,000 additional US troops is somehow going to improve the situation and security of women in Afghanistan?"

Asked what would she advise Obama in Afghanistan, Ramdas said he should set a time frame of less than five years to invert the balance of U.S. investments toward more development assistance and fewer military troops.

Even in the U.S., "the Third World is alive and well," she said. Close to 15 percent of the population is living below the poverty line, and 70 percent of them are women.

In 2007, 250,000 women and girls in the U.S. were raped or sexually assaulted. "How is it possible we don't see that as a public health crisis?" she asked.

"We must change the way we define health. It must be truly human security that we all fight for."