A vast body of evidence shows that utilising all human capital ¨C a country's most valuable resource ¨C by removing barriers to women¡¯s participation would lead to advances and improvements for all members of society.

But it remains a fact that and fewer than 10 per cent of institutional leaders are women. More and more academic scholarship is calling attention to the stark inequities that this gender bias generates.

Whether a business case for effectiveness, a human rights argument, or a moral imperative, the fight for gender equity to unleash the talent, potential and participation of women in societies has never been stronger.

However, ÖйúAƬ institutions are noticeably slow to act. Publicly funded institutions, many of which have produced evidence in favour of gender equity, are typically antiquated, hierarchical structures that are derived from medieval models of higher learning. They are thus structurally resistant (and also resilient) to change ¨C whether internally or externally driven.

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Worse, the too slow rate of integration of gender equity by institutions reflects a failure in the responsibility of ÖйúAƬ to deliver on the expectations of the public funding that supports them.

Why does this resistance continue? ?It seems there continues to be baggage that implies that structural change creating fairness and representation results in loss. Too often, we hear that excellence and equity are mutually exclusive.

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This defies evidence showing meritocracy to be a myth, and logic showing mediocrity to be a consequence of the status quo.

There is still resistance within institutions, from all members, as to the depth and breadth of scholarship in support of the value to all of gender equity. Gender stereotypes abound, reinforced in the media and by marketing, which limit the potential of both boys and girls, disenfranchising young people.

And within professional faculty, too few male leaders are expected to know and act on the evidence for gender equality. Women who do are branded activists, not leaders. The fear of rocking the boat, having difficult conversations, or a perception of special pleading further dissuades action.

But gender inequality is not an expression of biology or behaviour. In fact, it¡¯s wholly unrelated to ability and is instead a function of systemic factors including bias, organisational constraints and organisational culture.

And it can¡¯t be a result of the frequently cited ¡®pipeline problem¡¯ when disadvantages for women, like the gender pay gap, are shown to be unexplained by seniority, career breaks, and part-time work; and when discrimination exists against women at every stage of professional life. It is unconducive institutional environments that push women out of the pipeline.

Common excuses from institutions that the necessary structural change is too difficult are equally unacceptable. Many have been described and actioned in other sectors. These include legislation, allyship, leadership by scientific societies, professional development of core competencies in equity principles and inclusive leadership.

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And it is organisational change ¨C rather than individual-level interventions like mentoring, confidence-building, and networking designed to ¡®fix¡¯ women ¨C that will create durable and sustainable improvements in gender equality.

We acknowledge that progress has been made by institutions of ÖйúAƬ in the development of charters and guiding principles towards gender equality, collective shared goals, and commitments to equity, diversity and inclusion. These include initiatives such as Athena Swan in the UK, SEA Change in the US, and other equity, diversity, and inclusion pledges.

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Such charters and principles can set out expectations and provide a framework for accountability. But they now make ?even more obvious.

Universities have made massive contributions from research knowledge generation to the advancement of public health, medicine, science, and policy.

Findings generated by publicly funded institutions have improved the quality of life for many: from antibiotics to vaccines to the sanitation revolution. Based on scientific evidence, we recommend individuals get vaccinated. We do not continue to use posies and poultices simply because, ¡°we have always done it this way¡±, ¡°we don¡¯t want to offend anyone by changing the way we do things¡±, or ¡°we would prefer to trust opinion over data¡±.

The same is true when it comes to gender equity. Based on the best available evidence, now is the time to change what we are doing.

Institutions, which are made up of people ¨C flawed, complex human beings ¨C need to treat gender equity as an . The time for discussing whether equality should be pursued is over and we must now turn to experimentation and innovation, testing different strategies.

This means being open to failure and trying a variety of strategies to create gender inclusive workplace cultures that shift norms, value diversity and make people and the organisation accountable.

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Jocalyn Clark is executive editor of the The Lancet, and adjunct professor of medicine at the University of Toronto. She leads #LancetWomen, The Lancet¡¯s initiative on . Imogen Coe is professor of chemistry and biology at Ryerson University, where she was founding dean of its Faculty of Science.