The COVID-19 pandemic, however, has exposed critical gaps in national and regional health systems. Despite contingency plans at national and regional (EAC contingency plan for epidemics and other events of public health concern 2018-2023) levels, each country had constraints in healthcare workforce, financing, and healthcare service delivery. For example, most East African countries had not reached the recommended Abuja Declaration threshold of 15% of government budget earmarked to strengthen health systems and ensure their preparedness for emergencies. The policy makers faced difficult decisions in distributing scarce resources efficiently between increasing demands of pandemic response and the need to maintain the delivery of other critical services, while mitigating the impact on social and economic development which required great demands on the national budget. EAC states like Kenya and Rwanda significantly revised their budget allocation towards efforts to mitigate the impact of COVID-19 crisis. The public health measures to flatten the curve of COVID-19 spread also impacted social programmes, mobility and overall economic activities. The pandemic has exacerbated existing gaps in access to basic services and protection challenges, particularly for the most vulnerable groups. The report provides an analysis of the healthcare systems and socioeconomic disruptions at national and regional levels. The report also identifies the regional effects of COVID-19, and policy responses to this unprecedented crisis. While this report is largely focused on the health impacts of the COVID-19 crisis in the EAC, it is important to reflect on the socioeconomic impact and outcomes across the region. The ongoing COVID-19 epidemic waves, some linked with SARS-CoV-2 variants, continue to affect existing COVID-19 containment measures. A review of the national response among EAC member states provides an evidence-based approach to how countries have sought to balance public health measures and socioeconomic programmes to minimize the impact of the crisis on households and overall society.