The prevention of chronic disease and community-based initiatives are often funded by agencies outside recipient communities and for a short time (6 months–3 years). As a result, funding agreements often list ‘achieving program sustainability’ as a key objective. The expectation is that the initiative will continue in one form or another after the funding has ceased. This might look like the continuation of activities or benefits to the community, or the capacity of people or organisations to continue to address issues at a local level.¹ The Anticipatory Care (AC) Action Learning Project took a systems approach to the design and implementation of the initiative with a focus on strengthening the local system via local innovation, new collaborative opportunities, information sharing, and so on. As a result, sustainability is less about the continuation of activities and more about building relationships and the ongoing capacity of a ‘strengthened’ anticipatory care system to respond to change, including external shocks like COVID–19.

This policy brief applies a series of systemsbased concepts(see 2, 6-8) to the AC Project to further explore these questions. Findings from the AC Project demonstrate that concepts such as adaptation and self-organisation may be important in uncovering a local system’s capacity to sustain change and absorb shocks like COVID–19.