The United Nations Development Programme (UNDP) is developing a waste management planning tool for its Global Fund operations that works to improve waste treatment practices while also understanding the climate change impact associated with different disposal strategies. This study has supported the initiative by developing a first set of carbon factors for different waste management strategies to inform the planning tool. The project has focused on pharmaceutical waste management of antiretroviral tablets in Tajikistan. With this focus the study has reviewed the climate change impact of three waste management scenarios include onsite small scale incineration that has limited appeal due to its toxicological footprint and two alternatives that offer improvement.