Adhering to the brief: Global health images as repeated icons

Scholars and practitioners of global health humanitarianism have increasingly reflected on acceptable visual representation in global health, employing a range of terms such as biases, tropes and stereotypes, with a focus on "white saviourism" and "suffering subjects". We introduce the term global health iconography to advance this discussion, arguing that global health has historically reproduced four main kinds of highly-controlled image types (the icons) mapped around two binary oppositions: gazing vs intervening, referring to observing a photographic subject with or without intervention taking place; and suffering vs empowerment, referring to the implied state of the photography subject. We drew on interviews with 29 photographers (conducted December 2023 - May 2024) and analysis of images pulled from 50 global health organizations' websites to understand how photographers approached the creation of stereotypical images requested by their employers, and the mundane arrangements needed for assembling such images in communities. We find that institutionalized global health photography is a collective system of icon production in which pre-defined symbolic forms are repeated and normalized, while alternative representations get discarded as photographers are pressured to create images aligning with a recognizable visual canon. The paper argues that global health visual culture has been moving from an iconography of gazing at suffering to gazing at empowerment, mediated by public criticism and arcs of redemption resulting in iterative paradigm shifts. We conclude that decolonizing the global health visual culture requires a form of iconoclasm and not merely offering supposedly better icons as well as wrestling with the uneasy rise of generative AI imagery.