Around the globe many academic nursing and service organizations are developing programs across national borders to engage in global health improvement. Sustainability of global health programs requires planning in order to achieve outcomes that address change and innovation that continues after the visiting partners depart or the funding ends. Effective programs require program or project design factors that have been clearly defined, negotiated, adequately funded, and considered needs for training; include capacity building factors; and plan for sustainable innovations. Capacity building factors include structures and formal linkages, champions or leaders who engage stakeholders, administrative policies, adequate resources, and expertise to sustain innovations or program interventions. Attributes for sustainable innovations include the alignment between the program and the needs of the stakeholders, effective relationships, and ownership across stakeholder partners. This chapter presents a case study on sustaining public nursing education in Liberia.