[8] Cholera cases from this outbreak were also reported in neighboring countries South Africa, Malawi, Botswana, Mozambique, and Zambia.

[8] However, the severity of the 2008 has been attributed to a combination of societal factors including poor access to health care and poor health care infrastructure, high HIV prevalence, political instability, food shortages, high levels of displaced people, and lack of access to safe water.

[9][10] One of the major contributing factors to the outbreak was the breakdown of the municipal water supply, sanitation, and waste collection programs throughout the country, but especially in urban areas.

[14] Due to a shortage of purification chemicals, such as chlorine, the capital city of Harare stopped receiving piped water on 1 December 2008.

[16] On 4 December 2008, the Zimbabwe deputy minister for water and infrastructural development stated that there were only sufficient treatment chemicals in stock nationally for 12 weeks supply.

[20] A major contributing factor to the severity of the outbreak was the collapse of Zimbabwe's public health system, declared a national emergency on 4 December 2008.

Due to hyperinflation, hospitals were not able to buy basic drugs and medicines, and the resources of even internationally funded emergency clinics were stretched.

[65] On 10 December 2008, the Limpopo Provincial Government declared Vhembe District Municipality, which borders Zimbabwe at Beitbridge, Matabeleland South province, a disaster area.

[66] On a 28 January 2009 visit to Musina with high-ranking government and ruling party officials, Health Minister Barbara Hogan said Cholera is spreading... We are beginning to see a shift from Zimbabwe to South Africa.

[67] The spread of cholera to Zimbabwe's other neighbouring countries was initially slower than in South Africa, with one death recorded in Kafue District in Zambia and none in Botswana or Namibia by 9 December 2008.

[68] After the 2008 epidemic was declared a national emergency, the Ministry of Health and Child Welfare (MOHCW) collaborated with several other departments, governments, and non-governmental organizations to create a Cholera Command and Control Centre.

[72] Because of its well-organised health care system and effective water sanitation facilities, Rita R. Colwell of the James Baker Institute says Zimbabwe was historically one of the African countries least affected by cholera.

[72] A news commentator writing for The Lancet, Andrew Meldrum, said that President Mugabe's Youth Militia threatened health professionals that provided medical treatment to political opponents.

[74] He said that, combined with decreasing education standards, low pay, and a shortage of medical supplies like latex gloves, this led doctors to leave Zimbabwe at an alarming rate.

[75] According to Meldrum, Zimbabwe's high inflation left the country with a lack of financial resources, resulting in a shortage of ambulances and pharmaceutical drugs.

[76] Meldrum says that, during Zimbabwe's continuing HIV/AIDS dilemma, some major international donors did not give much money because they believed it would help President Mugabe stay in power, which they did not want.

[50] Marian Tupy of the Cato Institute said that the crisis began in 2005 when the government took over water treatment facilities but without sufficient funding to maintain purification processes.

[78] The lack of funding for water treatment chemicals, maintenance and staff salaries was cited by Colwell of the Baker Institute as a major cause of the epidemic.

[83] Said Ndlovu: Cholera is a calculated, racist, terrorist attack on Zimbabwe by the unrepentant former colonial power, which has enlisted support from its American and Western allies so that they can invade the country.

[87] Later that same day, Zimbabwean visas were denied to six French aid workers, including three crisis management specialists, two epidemiologists and a water treatment expert.