Despite the difficulty of making an agreement over cross-issue problem globalization brings about, why do some negotiations reach an agreement? This project deals with the linkage between TRIPS and access to HIV/AIDS medicines, which is one of the most important global issues in contemporary world and analyzes what factors are determinants in working out compromise of TRIPS in 2003. Different from the existing studies that focus on the role of the NGOs and norm, the project claims that the effects of TRIPS on the interests of pharmaceutical firms and the position of pharmaceutical firms in domestic health care politics were important determinants in the agreement of 2003. The approach of the project emphasizes the distributive effect of institutionalization of TRIPS on pharmaceutical firms and the effect of the distributive interests among pharmaceutical industry on government policy preferences for TRIPS.