Although the pandemic affects everyone, the risk of exposure and the impact on health and livelihoods are unequal.5 There are three main paths in which pandemics such as COVID-19 impact people differently and leave certain groups behind: through unequal risks of exposure and infection, through unequal direct health impacts, and through unequal indirect socioeconomic effects.The direct effects in health outcomes have been particularly felt by older persons and those suffering from chronic or long-term health conditions. The indirect effect of restrictions and mitigation policies aimed at minimizing the risk of transmission have also disproportionally impacted poorer individuals, informal workers, women, children, the youth, as well as migrants and ethnic minorities.6 Prior to the pandemic, some 900  million people were living in poverty on less than $3.20 per day. It is estimated that approximately 75–80 million people have fallen into extreme poverty because of the impacts of COVID-19. This report focuses on understanding the first path, specifically the interactions of characteristics and circumstances that impact people’s ability to protect themselves against pandemics. The report analyses how pre-pandemic living conditions may impact the ability to protect against infectious diseases, such as COVID-19. Pre-pandemic preparedness is important because a higher risk of infection also increases the likelihood of direct health impacts and indirect socioeconomic impacts.