This paper presents the ideas for the 2021 ImageCLEF lab that will be organized as part of the Conference and Labs of the Evaluation Forum-CLEF Labs 2021 in Bucharest, Romania. ImageCLEF is an ongoing evaluation initiative (active since 2003) that promotes the evaluation of technologies for annotation, indexing and retrieval of visual data with the aim of providing information access to large collections of images in various usage scenarios and domains. In 2021, the 19th edition of ImageCLEF will organize four main tasks: (i) a Medical task addressing visual question answering, a concept annotation and a tuberculosis classification task, (ii) a Coral task addressing the annotation and localisation of substrates in coral reef images, (iii) a DrawnUI task addressing the creation of websites from either a drawing or a screenshot by detecting the different elements present on the design and a new (iv) Aware task addressing the prediction of real-life consequences of online photo sharing. The strong participation in 2020, despite the COVID pandemic,