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.