The Agreement on Trade Related Aspects of Intellectual Property rights (TRIPS) requires all WTO members to adopt certain minimum standards for the protection of intellectual property rights including the rights of holders of patents for pharmaceutical products. The adoption of the standards delineated by the TRIPS Agreement appears to have resulted in significant loss of public health policy flexibilities for developing country members with respect to regulating the grant and use of pharmaceutical patents and controlling the cost of medicines. The Agreement, however, provides inherent flexibilities that are to enable member countries to take adequate measures to safeguard pubic health. This Study analyzes the extent to which countries in Sub-Saharan Africa (SSA) have been able to utilize the flexibilities to improve access to HIV/Aids medicines. This is done primarily in relation to the two regional intellectual property organizations, the African Regional Intellectual Property Organization (ARIPO) and Organisation Africaine de la Propriété Intellectuelle (OAPI), bearing in mind the close linkages between the legal instruments of these regional institutions and the domestic laws of their member countries. It has been observed that in spite of the availability of the flexibilities provided by the Agreement, obstacles to implementation in SSA center mainly on lack of awareness and political will and lack of efficient administrative structures and procedures for coordination and decision making. The Study also examines the option of local manufacture of HIV/Aids medicines, based on the experiences of four countries, evaluates challenges to the sustainability of this option in the SSA context and makes recommendations based on key findings.