Major sickle cell disease (primarily affecting SS, SC, and SB° individuals) is a major public health issue in France due to its high incidence: more than 400 newborns with this genetic disorder are born in France each year, corresponding to approximately 1,600 high-risk pregnancies. A national initiative must be undertaken to coordinate medical care for individuals with this disease, as well as screening and information for those at risk. Genetic counseling, which is required prior to any screening test, must be provided by professionals specifically trained in sickle cell disease, its management, and the multiple psychological, medical, and ethical challenges of genetic counseling. (R.A.)