Zimbabwe's 2008-09 cholera outbreak holds the dubious distinction of being Africa's worst on record. At the end of May 2009, the World Health Organization reported 98,424 cases of the disease and 4276 deaths. Other sources estimate that the number of cases has topped 100,000 since September 2008. ' The near-collapse of the country's water and sanitation infrastructure has dramatically reduced Zimbabweans' access to clean water and proper sewage treatment systems. With a case fatality rate of over four percent, Zimbabwe's cholera outbreak has exacerbated problems in a country already weakened by economic collapse and political mismanagement.Cholera outbreaks are relatively rare in the absence of war, so why did it happened in Zimbabwe in 2008 and 2009? We cannot understand the answer to that question without examining government policies and actions in the years prior to the outbreak. The cholera outbreak in Zimbabwe is both a humanitarian crisis and symptomatic of political decisions made by the Zimbabwean government. Cholera did not emerge out of nowhere in Zimbabwe; it emerged because government policies allowed it to emerge. Epidemics do not just happen. They are not random events. They have histories, write Barnett and Whiteside.2 We can identify direct relationships between the policies and decisions of President Robert Mugabe and his ZANU-PF (Zimbabwe African National Union- Patriotic Front) party and cholera's emergence. The takeover of municipal water supplies by the national government to weaken the opposition Movement for Democratic Change (MDC) and the government's economic mismanagement have worked in tandem to allow cholera to flourish.Understanding the underlying dynamics that gave rise to the cholera outbreak in the first place, though, does not necessarily tell us how we should respond to this humanitarian crisis. If the cholera outbreak in Zimbabwe occurred because the government did not effectively provide public goods to its citizenry, how can the social contract be reestablished? Does the international community have a role to play? If so, should it work through official state channels?This article has two goals. First, it seeks to demonstrate how infectious disease outbreaks like cholera in Zimbabwe are political crises as much as epidemiological ones. Specific government policies give rise to the conditions under which a disease like cholera can flourish. Second, it aims to outline potential remedies to prevent future cholera outbreaks. The international community can potentially play a role in preventing future cholera outbreaks in Zimbabwe, but the bulk ofthe burden lies with Zimbabwe. This speaks to larger questions about the role ofthe international community in protecting and promoting health worldwide. Health has traditionally been the province of national governments, but the international community has taken a greater interest in health and infectious disease in recent years. This has led to questions about the appropriate balance between the two, and the case of cholera in Zimbabwe offers us an opportunity to explore that balance.CHOLERA OUTBREAK IN ZIMBABWECholera spreads via a bacterium, Vibrio cholerae, where water supplies, sanitation, food safety, and hygiene practices are inadequate and poor sanitation and unsafe drinking water supplies predominate.3 Symptoms frequently occur within two to three days of exposure. These include a bloated feeling in the abdomen, generally with no accompanying fever, that quickly gives way to very watery stool. Cholera can cause severe dehydration and kidney failure, leading to death in as few as 18 hours. Without treatment, mortality rates can range from 50 to 90 percent, making it one of the most historically feared of diseases. However, treatment with oral rehydration therapies is remarkably effective if administered in a timely fashion, bringing the case fatality rate below one percent.Cholera also has a history of creating political divisions within societies. …