More transparency and efficiency is needed to improve the impact of HIV funding because the need for HIV services is increasing while the availability of funding is not, and in some cases decreasing, according to a new RAND Corporation study on Wednesday.

"The number of HIV/AIDS cases is going up, but donor funding isn't keeping pace," said Sebastian Linnemayr, the study's lead author and an associate economist at RAND, a nonprofit research organization in a statement. "That means we'll have to do a better job with existing resources -- by being both more transparent and more efficient in the way donor funds are spent."

RAND researchers evaluated the funding for antiretroviral therapy by the two largest funders which were the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria (GF), and analyzed how PEPFAR and GF had allocated resources to deliver services in recipient countries.

The study found that in 2010, 30 percent of PEPFAR’s $4.7 billion budget went to indirect services like health system strengthening, administration and overhead, which was more than what was spent on treatment at 28 percent of the budget.

The other 42 percent went to other direct services like prevention, testing and counseling, care and support, and orphans and vulnerable children.

Researchers acknowledged that while the proportion of funding for indirect and direct services was “to a degree intentional, PREFAR and GF should more clearly state the trade-off between providing current and future services, with funding decisions justified accordingly,” and that money used to strengthen the health system may cut future costs, but it reduces the money that can be used to provide immediate treatment for those living with HIV.

The researchers note that they could not determine the efficacy of the services provided by PEPFAR and GF because the expenditure data was not available, like the number of people on anti-retroviral therapy, and suggest that the data be made in a more transparent manner.

"Only then can steps be taken to compare efficiency between funders and over time," said Gery Ryan, an author of the study and a senior behavioral scientist at RAND. "That is the key to making sure resources are used in a way that maximizes the number of people receiving these life-saving services."

The study will be presented at a Congressional Briefing on Thursday.