To the extent that measures taken to combat Covid-19 intersect with existing trade and investment obligations for countries in the global south, and reveals the embedded tensions, we wonder whether regional governance can or should serve as a framework to create equitable and just South-South cooperation, especially in times of crises. Regional and sub-regional organisations, if operationalised effectively, have the capabilities to pool together the financial, human, and intellectual resources that will be needed to identify interventions and responses to measures that threaten the foundations of solidarity, self-reliance and equality underpinning South-South relations.