Crop from Leprosy poster-leaflet, 1955, Otto and Marie Neurath Isotype Collection, University of Reading

Whether employed to warn or impart information about symptoms, prevention, and infection, graphic design plays a significant role in the front-line response to infectious disease, making life-saving messages accessible to all. Examples of this can be seen in the bold graphics used to raise awareness of HIV/AIDS in the 1980s and in the NGO campaigns during the 2014 and 2015 Ebola outbreak. Further back, posters during WWII educated soldiers about the risks of malaria, and in the 1950s, Marie Neurath worked with health officials in Nigeria to put the famed Isotype information design system to use combating the spread of leprosy. 

Why then, media experts in the UK had been asking, was the government not harnessing our skills in a nationwide information campaign for the COVID-19 pandemic? “Public health is all about behavior change and a public health strategy lives or dies by the effectiveness of its communication,” wrote Sonia Sodha in the Guardian. “So far, communications experts… have their heads in their hands over the way this has been handled.” In recent days this has started to change. At daily No 10 press briefings, lecterns carry the message “Stay Home, Protect the NHS, Save Lives” displayed in a bright yellow box bordered by the red angled lines associated with warning. Last night, Guardian media editor Jim Waterson reported that new NHS-branded adverts would be running across social media and websites carrying a “blunt” warning beneath an image of a woman in protective clothing:  “If you go out, you can spread it. People will die.”

Last week saw the United Nations announce a first-ever open brief to creatives everywhere to help raise awareness and understanding of the Coronavirus and how to impede its spread. “We need to meet people where they are, with a stream of fresh, innovative content which drives home the personal behaviors and societal support needed today,” announced the call to action. The briefs come with WHO-provided knowledge and messages, with respondents asked to help translate “critical public health messages into different languages, different cultures, communities, and platforms, reaching everyone, everywhere.”

“A public health strategy lives or dies by the effectiveness of its communication.”

Rebecca Wright and I co-founded GraphicDesign& to advocate for our field. Our projects demonstrate how graphic design impacts what we notice, what we understand, and the actions we take. Over the past two years, we’ve originated exhibitions and produced books about health (Can Graphic Design Save Your Life?) and politics (Hope to Nope: Graphics and Politics 2008–18 and The Other Side). With the COVID-19 pandemic, these two worlds collide. Looking to the past, we see how effective the results can be when one facilitates and supports the other.

The following works and commentary are excerpts from a section in our provocatively titled book Can Graphic Design Save Your Life? chosen to show how design has historically played a vital role in communicating public health messages. Each makes a case for the positive impact communication design can have in matters of life and death. To provide context, we asked designers and experts to give commentary alongside the works, and to answer the question “Can graphic design save your life?”

Courtesy of Wellcome Collection

Florence Nightingale, Diagram showing mortality statistics of the British army in the Crimean War, 1958

Florence Nightingale traveled to Turkey in 1854 to support the British Crimean War campaign. She and 28 nurses collected data on soldiers’ health for seven months, encountering widespread disease and learning that bureaucratic processes hindered essential deliveries. The data was analyzed with the statistician William Farr. Nightingale’s visualization on the causes of deaths supported a report on battlefront conditions, to advocate for improved sanitation and administration. She incorporated graphs showing how most British army deaths in the war were preventable. She didn’t invent the polar area graph but imaginatively adapted it, using color, a wedge for each month, and extending the radius. This evidence supported a strategy that led to hospital and nursing reforms.

Peter Hall, design writer and researcher

Image © Estate of Abram Games

Abram Games, I’m Looking for You poster, 1941

My father, Abram Games, would certainly have hoped his posters could save lives. He believed that designers should create in the interest of humanity and be conscious of their responsibilities. Before, during and after the war, he designed many safety posters for The Royal Society for the Prevention of Accidents and for aid appeals for victims of the Spanish Civil War. During World War Two, many of his posters were adapted for civilian use. He designed 100 posters between 1940 and 1945, and became the only ever official war poster artist in 1942. 

Games designed instructional, educational and training posters, with messages on guarding against careless talk and the handling of weapons and ammunition, instructions about how to be economic and less wasteful, information on medical and dental care, and as part of campaigns that called for blood donors and encouraged the growing of food. His posters urging for help for the victims of the Holocaust were particularly effective and he did much of this work gratis.

He was never concerned about whether the viewer liked his posters but was resolute that his posters should always be noticed. After 1945, he hoped the government would continue to publish posters with an ethical, social and educational message. He continued to design posters for cancer prevention and other campaigns. He was particularly proud of his 1960 Freedom from Hunger poster for the United Nations and was always determined that his posters should be a power for good. If they saved just one life, he would have been satisfied.

—Naomi Games, daughter of Abram Games and author of six books about her father’s legacy

Image © Estate of FHK Henrion

FHK Henrion, VD—A Shadow on Happiness poster, 1943

FHK Henrion’s famous wartime posters warning against the danger of VD were more successful than he, and the Ministry of Health who commissioned them, bargained for. In 1940s Britain, posters were the equivalent of today’s TV ads. They were the street-corner version of web banners and high-powered press ads. The poster was the dominant pre-electronic messaging system, and Henrion was a master of the medium.

So persuasive were Henrion’s VD posters that they caused people without the disease to visit their local doctor. It says something about the power of graphic design to change the way people behave, but can we really say that graphic design has the power to save lives?

Graphic design is like dentistry, it’s a discipline and needs an expert to make it work. It’s not graphic design or dentistry that saves lives, it’s people. If I design a sign for a busy road junction and it’s unreadable, resulting in road accident deaths, it’s not graphic design that’s at fault, it’s the idiot who designed the sign—that’ll be me, in this case.

Attributing autonomous qualities to graphic design—or dentistry—is obtuse. It’s why I have a problem with terms like “critical design,” “social design,” and “speculative design.” Design is none of these things, but you can have critical designers, social designers and speculative designers.

However, perhaps with the inevitable rise of automated, artificial intelligence-driven design, we might, in the future, come to regard design as an autonomous force that can save lives. But when that day comes [some say it’s already here], it also means that we will have graphic design that destroys lives.

Adrian Shaughnessy, design writer and author of FHK Henrion: The Complete Designer

Courtesy of Otto and Marie Neurath Isotype Collection, University of Reading

Marie Neurath, Leprosy poster-leaflet, 1955

Graphic design is unlikely to save lives in any direct way—it is more likely to enable actions that do. More likely still, graphic design may improve lives rather than save them, though even here probably as one of several factors helping to do so. In search of examples, one might profitably turn to graphic design dealing with health. One example is work done by Marie Neurath in the Western Region of Nigeria in the mid-1950s. It offers evidence of graphic design intended to encourage good health and improve lives, and perhaps even save some.

As director of the Isotype Institute, Neurath visited hospitals, clinics, medical field units and a leprosy center in the Western Region. Recognizing a need for basic information among the population, she drew on the experience and knowledge of local health workers and the support of the minister of health to devise poster-leaflets explaining health concerns, including leprosy. As designed, the poster-leaflet for leprosy unfolded—figuratively and literally—the disease and its treatment.

Using unambiguous language and simple graphic arrangements, the aim was to inform and enable action. The poster-leaflet could be taken away and kept, or passed on to others. Did it work? We don’t actually know. Fifty thousand were printed, some in English, some in Yoruba, and shipped to the Western Region. But, try as she might, Neurath could not discover from officials whether it functioned as intended, had any effect on leprosy diagnosis and treatment, or mitigated people’s fear. Yet the example is a valuable one, providing evidence of graphic design deployed to improve the lives of those with a disease whose stigma added to its debilitating effects. At the time leprosy was curable, but if left untreated could be fatal. So, to the question, ‘Can graphic design save your life?’ Marie Neurath’s work may go some way towards an affirmative answer.

Eric Kindel, head of the department of typography & graphic communication at the University of Reading and curator of the Otto and Marie Neurath Isotype Collection

Image © 1987 The Silence=Death Project

Gran Fury, Silence=Death poster, 1987

ACT UP was aggressive because it had to be. Authorities and the media, especially in America, weren’t listening—so by speaking out, making art and getting it on to the streets, ACT UP was a way for infected gay men to show that they weren’t going to die quietly. To be silent was to be passive. The pink triangle was re-appropriated to become a symbol of hope, turning anger into something positive.

In the prints I made for Boy George and Culture Club’s world tour, I mixed the triangle with other symbols such as the Star of David and the CND logo to make a design with a heart at the center. It looks like the universe, chaos becoming order, order becoming chaos.

Friends here in New York and in the UK were affected by the AIDS crisis. I think the ACT UP poster shows that graphic design can save lives if it challenges what people think and do.

Ben Copperwheat, artist and print designer

Illustration by Samba Cisse, concept by UNICEF Health Education Division

Samba Cisse, Ebola poster, 2014

From our experience, we know that [graphic design] has a significant role to play in communities and societies challenged with poor levels of literacy, or that are multilingual or multicultural. In these scenarios, graphics are directly linked to effective communication, including saving lives. 

The social development sector has for years exploited the potential of graphic design to achieve its goals—improving human well-being and development. From the materials used to engage community stakeholders to outdoor media or animation, the core principles of visual communication guide the entire gamut of non-verbal communication. Most critically, graphic design helps break down one of the biggest barriers to development and community engagement, unlocking the flow of information and knowledge and freeing it from old associations of power.

During the Ebola outbreak in West Africa, graphic design played an integral role in communicating with a culturally and linguistically diverse population with minimal formal literacy. While radio was one of the most effective media in reaching the nationwide population, it was the posters, flyers and counseling cards that showed the signs and symptoms of the disease. The easy-to-comprehend information, education and communication materials were all pre-tested for audience perception, understanding and socio-cultural acceptability, and were used by health workers and social mobilizers to promote and educate the population. Although no formal research was conducted, empirical evidence indicates that, once rolled out in the communities, there was a shift in acceptance regarding the prevalence of Ebola and the adoption of positive behaviors—and, eventually, lives were indeed saved.

— Kshitij Joshi, chief of communication for development at UNICEF Sierra Leone

Lucienne Roberts is founder of studio LucienneRoberts+ and co-founder of advocacy initiative GraphicDesign&, research and practice that is characterized by an abiding interest in the role of communication design in the wider world and in definitions of ethical design. A graduate of Central Saint Martins, she is a member of the Alliance Graphique Internationale and co-founded Graphicdesign& with Rebeeca Wright, Dean of Academic Programmes, Central Saint Martins, University of the Arts London.