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J R Soc Med. 2006 December; 99(12): 646.
PMCID: PMC1676318

Fear ever young: the terrorist death toll in perspective

Why are people not afraid of driving? There are plenty of people afraid of flying, and the terrorist attacks of 2001 can only have exacerbated this phobia. Whenever you board a plane you can see them: anxious passengers gripping their boarding passes so hard they jam the automated counters at the boarding gates. Where are the masses sweating and shaking with fear as they climb into their cars?

Clearly fear is not always founded in facts. Every year over one million people around the world die in road traffic accidents, compared with about one thousand deaths from plane crashes. The difference is that every fatal plane crash makes the news whereas most car accidents remain anonymous. In their safety briefings, flight attendants never warn you that you are sixty times more likely to die driving home from the airport than during the flight.1

This bias in reporting deaths also applies to terrorism. One individual taken hostage and murdered by some extremist group makes news headlines worldwide. If the BBC World Service tried to report each AIDS death for one year, the broadcast would take more than a year to deliver—even without interruption and allowing just 10 seconds per death. If we considered tobacco-related deaths, even two simultaneous news bulletins couldn't keep up with the death toll.

Everyone remembers where they were when those planes crashed into the World Trade Center killing three thousand innocent victims on 11 September 2001. It changed human history. But how many people know that on the same day five years ago, more than four thousand children died of diarrhoea, three thousand people died in car accidents, and eight thousand died of AIDS?2 In 2003 the collective annualized mortality burden from tobacco was more than five thousand times that of terrorism.3 Furthermore, these deaths continued unabated on 12, 13 and 14 September, and every day since. The even greater tragedy is that they were preventable. Despite the billions being spent on ‘the war on terror’, are we any safer?

There is no question that terrorism is a global problem that needs to be addressed. However, as Jeffrey Sachs explains, ‘We need to keep September 11 in perspective, especially because the ten thousand daily deaths (from AIDS, TB, and malaria) are preventable.’4

Figure 1
Relative magnitude of global deaths in 2001 from selected causes. Data taken from the WHO World Health Report, 2002. Total area of figure corresponds to global deaths in 2001. RTA, Road traffic accidents, TB, Tuberculosis


Competing interests The author holds a pilot's licence.


1. National Safety Council. What are the odds of dying? Available at (accessed 15 October 2006)
2. WHO. World Health Report, 2002. Available at (accessed 15 October 2006)
3. Thomson G, Wilson N. Policy lessons from comparing mortality from two global forces: international terrorism and tobacco. Global Health 2005;1: 18. [PMC free article] [PubMed]
4. Sachs J. The End Of Poverty. How We Can Make It Happen In Our Lifetime. London: Penguin, 2005: 215

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press