COVID-19 and its control measures remain contested issues in literature. While some of the literature views COVID-19 and its responses as neutral events serving the common good, other parts of the literature considers them partial events serving personal interests. This study analyses the political economy of COVID-19 in East Africa by assessing how COVID-19 and its control affected public and private policy actors and how the actors responded to them. Based on a systematic review, the study found that the pandemic and its control generated political and economic opportunities and contestations. Politically, COVID-19 and its control measures presented opportunities to suppress and oppress opposition, conduct political campaigns, provide patronage, and conduct selective enforcement. Economically, the pandemic and its responses presented opportunities to generate income and benefits for the government and its employees, businesses, and ordinary citizens. However, these opportunities were exploited to serve personal political and economic interests. COVID-19 responses also generated a lot of discontent, leading to contestations from many policy actors. The actors contested COVID-19 vaccines and science, role allocation during the response, selective enforcement of COVID-19 directives, corruption in relief provision, and the brutality of security forces. The contestations and pursuit of personal political and economic interests compromised the effectiveness of the COVID-19 response.