Designing for social good framed within an ethical practice has a long tradition informed by the democratic philosophy of John Dewey, but more recently it has been acknowledged that co-design can embody cultural respect and empathy through an expressed purpose. Using the principles of co-design, a northern European university took a small group of graphic design students to Mozambique to participate in a practice-led research project with local youth groups. The focus was on promoting malaria awareness and preventative education in an area of Africa where the disease is endemic despite large interventions from NGOs. This study examines the iterative process of the co-design project and how it responded to the challenges of a post-colonial environment to deliver a method of communication that was valid and participatory. When people engage in a co-design process, they also engage in ethics, in a process with embedded ethical, reflective and social qualities based on lived knowledge. If design-based social change is going to be effective and sustainable, it must be rooted in empowerment, and not solely dependent on the designer. Applied through this ethical and democratic approach, co-design could provide an engaging new strategy to solve some of the world’s greatest social problems.