Even prior to COVID, health and ill-health were not equitably distributed in Uganda. History has shown that public health emergencies such as COVID can have a disproportionate impact on communities that are already disadvantaged. Not paying explicit attention to existing inequalities and the particular needs of vulnerable and marginalized groups subjects them to a higher risk of infection and also undermines the broader response to COVID. It is already clear that not only does COVID disproportionately affect people who are already vulnerable due to comorbidities that are often a result of pre-existing social inequalities, but mitigation and policy responses in Africa have disproportionate negative impacts on socially marginalized or disadvantaged groups. People with underlying conditions (e.g. cancer, diabetes, being immunocompromised) are disproportionately vulnerable to severe illness from the coronavirus. Adherence to government response measures might be compromised by a range of factors, with poverty prime amongst them. The pandemic has shone a light on pre-existing societal inequalities and it is now exacerbating them.