The COVID crisis has cast its dark shadow in the IGAD region at the worst time as it came on top of problems of the weak or fragile states, lack of capacity, widespread poverty and food insecurity, conflicts, and the desert locust invasion. Many of the member countries are also under major economic difficulties and has significant vulnerable populations and large numbers of internally displaced persons and refugees. This study provides an overview of the pre-COVID socio-economic situation and state of health services, cooperation and collaboration among member countries and discusses the outbreak and spread of the virus, and its broad adverse health economic and social impacts. It then discusses the rescue and social safety net measures being taken and financing, and highlights some key issues that recovery efforts in the region should take into account, stressing the importance of sustainability and inclusivity.