ASLM issues lab-waste tools
ASLM, supported by PEPFAR, released a resource package and decision matrix for safe laboratory waste management from molecular HIV viral-load and early-infant-diagnosis platforms, covering handling of guanidine-based reagents. The toolkit compiles country-level practices and practical tools from nine African countries for safer disposal and platform-specific guidance (x.com).
African Society for Laboratory Medicine has released a new package of tools for disposing of hazardous waste from HIV molecular testing, including a decision matrix for reagents that contain guanidinium chemicals. (aslm.org) The group published the guidance on March 30, 2026, with support from the U.S. President’s Emergency Plan for AIDS Relief, or PEPFAR. It covers waste from HIV viral-load testing and early infant diagnosis, the nucleic-acid tests used to monitor treatment and detect infection in babies too young for standard antibody tests. (aslm.org; clinicalinfo.hiv.gov) The core problem is chemical, not just medical. The ASLM document says guanidinium thiocyanate and guanidinium isothiocyanate, used in nucleic-acid extraction, can create toxic gas if they are mixed with bleach during cleanup or disposal. (aslm.org; cdc.gov) ASLM said the package draws on implementation experience from nine countries: Eswatini, Ethiopia, Kenya, Malawi, Mozambique, Nigeria, Uganda, Zambia and Zimbabwe. The toolkit includes a disposal-options matrix, decision tools and work instructions for national programs, laboratory managers and waste handlers. (aslm.org) The longer technical document runs through specific disposal routes, including cement encapsulation, cement kilns, high-temperature incineration, precipitation methods for guanidinium waste and cross-border shipment under Basel Convention rules. It also includes platform-specific work instructions for liquid waste and used cartridges. (aslm.org) ASLM published a second document the same day on choosing and financing laboratory-waste systems. That framework says many countries still face limited treatment infrastructure, weak enforcement, thin technical capacity and fragmented national waste systems. (aslm.org) The guidance lands as HIV testing networks remain large and heavily used. PEPFAR said it was supporting treatment for 20.6 million people across 55 countries as of Sept. 30, 2024, and reported viral suppression in 95% of adults and 89% of children on treatment in those programs. (state.gov) That testing scale has been building for years, and the waste problem has been building with it. A 2021 paper on 11 African countries found policy, regulation and practice gaps in handling guanidinium-containing waste from HIV molecular testing as countries expanded viral-load services. (sciencedirect.com) ASLM had already issued a viral-load and early-infant-diagnosis waste tool in 2019 and a cookbook on guanidinium waste in 2023. The 2026 package turns those earlier lessons into a broader set of country-tested instructions as more laboratories add molecular platforms and generate larger volumes of chemical waste. (aslm.org; aslm.org) The immediate change is practical: laboratories and health ministries now have a March 2026 playbook for deciding what to do with one of the most difficult waste streams produced by HIV molecular testing. ASLM’s framing is narrow and operational — protect workers, avoid toxic reactions and keep expanding diagnostics from creating a parallel disposal hazard. (aslm.org; aslm.org)
