The use of imagery in global health: an analysis of infectious disease documents and a framework to guide practice

Framework for the use of imagery in global health
Elsevier, The Lancet Global Health, Volume 11, Issue 1, January 2023, Pages e155-e164 
Esmita Charani, Sameed Shariq, Alexandra M Cardoso Pinto, Raabia Farooqi, Winnie Nambatya, Oluchi Mbamalu, Seye Abimbola, Marc Mendelson

We report an empirical analysis of the use of imagery by the key actors in global health who set policy and strategy, and we provide a comprehensive overview, particularly related to images used in reports on vaccination and antimicrobial resistance. The narrative currently depicted in imagery is one of power imbalances, depicting women and children from low-income and middle-income countries (LMICs) with less dignity, respect, and power than those from high-income countries. The absence of any evidence of consent for using intrusive and out-of-context images, particularly of children in LMICs, is concerning. The framework we have developed provides a platform for global health actors to redefine their intentions and recommission appropriate images that are relevant to the topic, respect the integrity of all individuals depicted, are accompanied by evidence of consent, and are equitable in representation. Adhering to these standards will help to avoid inherent biases that lead to insensitive content and misrepresentation, stigmatisation, and racial stereotyping.