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Due to the ongoing COVID-19 pandemic, efforts to promote health and well-being by reducing harms related to alcohol misuse are likely to be adversely affected by changing sales and policy environments, as well as social distancing requirements imposed to halt virus transmission. In response, the AB InBev Foundation adapted an initiative originally developed to reduce harmful alcohol drinking in five global “City Pilot” demonstration sites that sponsored partnerships between local coalitions and public institutions to reduce alcohol-related harms. Little is known about the effects of a prolonged pandemic on access to alcohol, alcohol misuse and related harms, and ongoing interventions designed to prevent or mitigate these harms. Participants in Community Steering Committees (SteerCos) associated with each City Pilot provided information about the history of the project and the context of implementation during the COVID-19 pandemic. We found that, where feasible, the City Pilots adapted their in-person prevention strategies for online delivery. They also modified the purpose of a Foundation-sponsored fund that was originally intended to support community-based alcohol harm prevention efforts. As repurposed, this fund financed local COVID-19 prevention and emergency response efforts and generated goodwill with community partners.