The elephant in the room reflecting on text-to-image generative AI and global health images

There has been increasing evidence that generative AI produces biased, exaggerated and otherwise problematic images with regard to class, race and gender, among other socially enacted markers.1 2 Further extending these concerns to global health and text-to-image generation,3 in this commentary article we discuss ‘the elephant in the room’ both as a metaphor for global health,4 visual culture and stereotypical depictions of ‘Africa’, and in the literal sense, as shown in figure 1.