Abstract
Simmering beneath the surface of France's centrally coordinated response to COVID-19 is a long-standing tension between two French public health traditions. The first tradition has been the foundation of the French state's historical engagement with global humanitarian health, which we have previously described as state humanitarian verticalism.1 Instituted first in the French former colonies, it was widely used in France's international health assistance, including during epidemics, and is still part of France's global health assistance in low-income countries.
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