 Millions of people, especially in low- and middle-income countries, lack access to medicines because they're not affordable. Despite significant technological advances made in the medical field, getting medicines to those who need them remains a major challenge. A recent report on global health expenditure from the World Health Organization found that on an average, more than 35% of health spending per country comes from out-of-pocket advances, resulting in 100 million people getting pushed into extreme poverty each year. In low- and middle-income countries, approximately 20-60% of all health expenditure is out-of-pocket. Affordable medicines are hence crucial at the national level. Sustainability of government's provision of public health at the national level also very much depends on the availability of affordable medicines. Access to medicines, a fundamental element of the universal human right to health, depends on several factors, such as prices, rational medicine selection processes, sustainable financing, and reliable healthcare and supply systems. But the price factor can singularly be determinative of life or death, where a deadly disease is treatable but the treatment is unaffordable. The challenge of high prices has been confronted within the context of treatable infectious diseases such as HIV-AIDS and hepatitis C. In 2000, the lowest price for a triple-combination first-line antiretroviral treatment was over $10,000 for a year's supply. However, the availability of generic versions of the medicines led to significant price reductions. In 2001, SIPLA, an Indian Generic Manufacturer, offered the same combination for $350. Over time with increased generic competition, the cost is now less than $99, aiding the global scale-up of HIV-AIDS treatment. In 2013, the pharmaceutical company Jilid launched Sufis Buvir, a hepatitis C cure, with $84,000 list price for a 12-week course of treatment. In countries with robust generic competition, the prices dropped to less than $300 for the same treatment course, helping government to scale up treatment. In other countries, treatment is rationed. Drug competition among multiple manufacturers is crucial for reduced prices, which has been under threat since the implementation of the trade-related aspects of intellectual property rights, one of the multilateral agreements of the World Trade Organization, commonly referred to as the TRIPS Agreement. With TRIPS Agreement coming into force, WTO members became bound to observe a set of minimum standards for intellectual property protection, failing which a country may be challenged in WTO's dispute settlement mechanism and phase trade retaliations. One of these minimum standards is the obligation to grant patents in all fields of technology, including pharmaceutical product patents for at least 20 years from the date of filing of patent application. Prior to the TRIPS Agreement, countries had freedom to design their national intellectual property regime under the Paris Convention. Countries could exclude entire fields of technology from protection, provide a short patent duration and take steps to promote the competition in the pharmaceutical sector. In the TRIPS era, most developing and some developed countries excluded pharmaceutical products from patent protection. For instance, an amendment in 1969 to the Brazilian legislation declared pharmaceutical products and processes non-patentable. In 1970, India implemented a similar policy that eventually led to the development of a robust local pharmaceutical sector, helping her become the leading supplier of affordable generic medicines to many countries. The TRIPS Agreement initiated a paradigmatic change with implications on access to affordable medicines. This sparked an international debate on the relationship between intellectual property and the right to health. Given the lack of access to a sustainable supply of affordable medicines for treatment of infectious and non-communicable diseases, intellectual property may aggravate this situation. The minimum 20-year patent protection required by the TRIPS Agreement allows a pharmaceutical company monopoly over the production, marketing and pricing of patent-protected medicines, thereby curbing competition and keeping prices high. This monopoly period is often extended by the patent-holding company through strategies such as patent evergreening, that is applying for patents on different uses, forms and combinations of a known medicine. While imposing minimum intellectual property obligations, the TRIPS Agreement also provides WTO members significant policy space to interpret and implement the different provisions of the agreement and to take measures to promote access to medicines. This policy space is popularly referred to as TRIPS Flexibilities.