Putting people and diseases into the picture: Towards an ethics of global health visuals

In recent years, global health institutions and practitioners have increasingly been using images of people in communities; suffering, expressing resilience or receiving care. The aim of these images is pragmatic: to tell a compelling story, establish emotional affinity, attract funding and communicate global health to stakeholders and the general public.

Once an image depicting an intervention is published on behalf of an institution, it becomes something else: a global health image, through which people learn, interpret and judge global health at large. Such images unavoidably become media that actively communicate ideas, values and clichés concerning disease susceptibility, race, class, gender, sexuality, age, able-bodiedness, North and South. As more and more of these visuals are being disseminated globally, both online and offline, timely critical reflection and normative guidance on what makes a global health image good or bad is lacking.

The challenges inherent in ‘putting people into the picture’ come to the fore in light of the global call for decolonizing global health and building a fairer and more just system, wherein careful and reflective visual representation is a must. This requires not only evaluating the ethics of the images’ content, but also finding ways to ethically use the images without abusing the contexts in which they were taken.

Against this background, this project aims to take global health images seriously through the lenses of transdisciplinary bioethics. Drawing on insights from semiotics, visual anthropology, post-colonial studies, and science and technology studies (STS), this pilot project lays out five core tasks:

• To identify and evaluate visual tropes and patterns that are present in contemporary depictions of people and communities in global health, as well as the visual-structural elements that constitute such images.
• To put visual tropes and patterns into a historical context and trace their evolution and potential commensurability by juxtaposing archival colonial medicine visuals with contemporary global health visuals.
• To gain an understanding of the ways in which contemporary depictions of people and communities in global health are routinely planned, staged, taken, chosen, edited and disseminated by global health institutions, and subsequently to identify both resolved and persisting ethical issues.
• To develop community engagement and bottom-up interventions that could allow the public to take a more active role in influencing the ways in which people are depicted by global health institutions.
• To contribute to transdisciplinary bioethical theory centring on visual representation and produce a practical guide for institutions operating with global health images.

Publications

• Alenichev A, de Laat S, Solomon N, Suwalowska H, Peeters Grietens K, Parker M, et al. (2024) Assembling a global health image: Ethical and pragmatic tensions through the lenses of photographers. PLOS Glob Public Health 4(2): e0002540. https://doi.org/10.1371/journal. pgph.0002540
• Arsenii Alenichev, Patricia Kingori, Koen Peeters Grietens, Reflections before the storm: the AI reproduction of biased imagery in global health visuals, The Lancet Global Health, 2023, DOI:https://doi.org/10.1016/S2214-109X(23)00329-7

Project team

• Arsenii Alenichev Ethox Centre, Wellcome Centre for Ethics & the Humanities, University of Oxford, UK
• Sonya De Laat McMaster University, Canada
• Koen Peeters, Institute of Tropical Medicine Antwerp, Belgium
• Marla Shaivitz Johns Hopkins Center for Communication Programs, USA
• Nassisse Solomon Western University, Canada
• Halina Suwalowska Ethox Centre, Wellcome Centre for Ethics & the Humanities, University of Oxford, UK