The Lancet
May 28, 2016 Volume 387 Number 10034 p2163-2262 e28
http://www.thelancet.com/journals/lancet/issue/current

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Editorial
Eliminating FGM: what can health professionals do?
The Lancet
Summary
Female genital mutilation (FGM)—defined by WHO as “procedures that involve the partial or total removal of external genitalia or other injury to the female genital organs for non-medical reasons”—is internationally recognised as a violation of the human rights of girls and women. Worldwide, more than 200 million girls and women suffer the physical and psychological consequences of FGM. FGM is a harmful practice and can cause several immediate and long-term health consequences such as haemorrhage, post-traumatic stress disorder, painful urination, and complications in childbirth.

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Comment
Yellow fever: the resurgence of a forgotten disease
Margaret Chan
Published Online: 23 May 2016
Summary
The possibility that a mosquito bite during pregnancy could cause severe brain damage in newborn babies has alarmed the public and astonished scientists. The Zika outbreak in the Americas shows how a disease that slumbered for six decades in Africa and Asia, never causing an outbreak, can become a global health emergency. The Ebola and Zika outbreaks have revealed gaping holes in our lines of defence: weak health infrastructures and capacities in west Africa and the demise of programmes for mosquito control in the Americas.

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Series
France: nation and world
Achieving universal health coverage in France: policy reforms and the challenge of inequalities
Olivier Nay, Sophie Béjean, Daniel Benamouzig, Henri Bergeron, Patrick Castel, Bruno Ventelou
2236
Summary
Since 1945, the provision of health care in France has been grounded in a social conception promoting universalism and equality. The French health-care system is based on compulsory social insurance funded by social contributions, co-administered by workers’ and employers’ organisations under State control and driven by highly redistributive financial transfers. This system is described frequently as the French model. In this paper, the first in The Lancet’s Series on France, we challenge conventional wisdom about health care in France. First, we focus on policy and institutional transformations that have affected deeply the governance of health care over past decades. We argue that the health system rests on a diversity of institutions, policy mechanisms, and health actors, while its governance has been marked by the reinforcement of national regulation under the aegis of the State. Second, we suggest the redistributive mechanisms of the health insurance system are impeded by social inequalities in health, which remain major hindrances to achieving objectives of justice and solidarity associated with the conception of health care in France.

France: nation and world
State humanitarian verticalism versus universal health coverage: a century of French international health assistance revisited
Laëtitia Atlani-Duault, Jean-Pierre Dozon, Andrew Wilson, Jean-François Delfraissy, Jean-Paul Moatti
2250
Summary
The French contribution to global public health over the past two centuries has been marked by a fundamental tension between two approaches: State-provided universal free health care and what we propose to call State humanitarian verticalism. Both approaches have historical roots in French colonialism and have led to successes and failures that continue until the present day. In this paper, the second in The Lancet’s Series on France, we look at how this tension has evolved. During the French colonial period (1890s to 1950s), the Indigenous Medical Assistance structure was supposed to bring metropolitan France’s model of universal and free public health care to the colonies, and French State imperial humanitarianism crystallised in vertical programmes inspired by Louis Pasteur, while vying with early private humanitarian activism in health represented by Albert Schweitzer. From decolonisation to the end of the Cold War (1960–99), French assistance to newly independent states was affected by sans frontièrisme, Health for All, and the AIDS pandemic. Since 2000, France has had an active role in development of global health initiatives and favoured multilateral action for health assistance. Today, with adoption of the 2030 Sustainable Development Goals and the challenges of non-communicable diseases, economic inequality, and climate change, French international health assistance needs new direction. In the context of current debate over global health as a universal goal, understanding and acknowledging France’s history could help strengthen advocacy in favour of universal health coverage and contribute to advancing global equity through income redistribution, from healthy populations to people who are sick and from wealthy individuals to those who are poor.