In this paper, we explore the Covid-19 pandemic’s evolving impacts and wide-ranging local initiatives in Mogadishu, Kampala, and Nairobi. Low-income residents often experienced Covid-19 less as a health crisis (especially in its early waves) and more in terms of its devastating socioeconomic, political and violent impacts. Although there were widespread misconceptions about the virus and vaccine, private sector and civil society groups also raised awareness about Covid-19 via several creative initiatives  that can usefully complement official risk communication strategies. Moreover, we found a range of Covid-19 responses at different scales, including national taskforces; philanthropic and private sector initiatives; aid agency initiatives; and grassroots and other civil society interventions. Some new collaborations and constructive  engagements emerged between state and non-state groups. An array of non-state actors – including community health volunteers (CHVs), private firms, youth, women’s, faith-based and refugee-led organisations – were key in assisting marginalised residents, but these efforts would benefit considerably from additional government  support and recognition. We develop a typology of responses that ranges from quite top-down coalitions to increasingly bottom-up community solidarity networks. The typology encompasses efforts around emergency relief distribution, risk communication, service delivery, livelihoods strengthening and data collection.  Collaborations between state and non-state actors took various forms but were typically emergency responses, which did not necessarily adopt a strategic, longerterm approach to addressing urban poverty and deprivation. Other interventions – such as enhancing health systems, countering police brutality, supporting multi-sectoral  upgrading and engaging constructively with informality – may open newfound  possibilities of more lasting, equitable change.