The Use and Creation of Photographic Imagery in Global Health: Actionable Steps Towards Decolonization by Academic Institutions.

Background: Photographic imagery holds profound power in shaping narratives, identities, and perceptions in global health education. Historically, visual representation used in global health has perpetuated colonial hierarchies, reinforcing inequities and marginalizing the voices and lived realities of the communities they depict. These images can inadvertently sustain harmful stereotypes and distort the complexity of global health challenges. Findings: This paper explores the ethical imperative of decolonizing photographic imagery within academic global health, proposing a comprehensive multi-level framework for change targeting institutions, faculty, and students. At the institutional level, strategies include developing formal ethical image-use policies, establishing accountability structures, and providing ongoing training to center principles of informed consent, dignity, and cultural context in image selection and use. Faculty have a critical role in modeling ethical practices by selecting imagery in research outputs and teaching materials, integrating visual ethics into curricula, and fostering classroom dialogue that encourages critical reflection on representation and power dynamics. Educators can actively engage students by empowering them to contribute their own experiences, thereby reshaping dominant visual narratives. Collaboration with community partners in co-creating authentic and respectful images is essential, alongside mechanisms for continuous evaluation and accountability to sustain ethical standards over time. Recommendations: We recommend that academic institutions adopt institution-wide ethical image-use policies, offer training programs for faculty and students, and develop centralized image repositories that include culturally appropriate and consented visuals. Faculty should integrate ethical image practices into research and pedagogy, while creating spaces for students to reflect on diverse perspectives. Building meaningful, ongoing partnerships with community stakeholders is crucial to ensuring that images represent the diversity and dignity of global health realities. Conclusions: By advancing a culture of ethical reflexivity and accountability around photographic imagery, academic institutions can dismantle colonial visual legacies and foster more equitable, inclusive, and humanizing global health education and practice.