During the past few decades, western countries have pushed for strengthening intellectual property (IP) rights, as well as enforcing them uniformly across the globe. This push came to a climax when the IP was removed from the World Intellectual Property Organization (WIPO) to become a trade issue under the World Trade Organization (WTO). Western countries were instrumental to crafting the Trade-Related Aspects of Intellectual Property Rights (TRIPs) as an item in world trade negotiations and agreements through WTO in 1995. Although many of the TRIPs requirements seemed favored producers as opposed to consumers of IP, developing countries have nevertheless been obliged to enact domestic legislation to implement the requirements of TRIPs. This paper examines the implications of the TRIPs Agreement on access to HIV/AIDS drugs in African countries, and offers a framework for analyzing the international and domestic factors which offer constraints and opportunities for relevant public health policy development and implementation in Africa.