Sub-Saharan Africa (SSA) has become a hotspot for global terrorism, with nearly 50% of global terror-related deaths occurring in SSA in 2021. To address growing terrorism-related health implications the field of counter-terrorism medicine (CTM) seeks to study the impacts of terrorism and implement healthcare initiatives. This study is a semi-quantitative analysis of terrorist-related activity in SSA from 1970-2020.

A retrospective analysis of the Global Terrorism Database (GTD) was performed for the region of SSA between 1970-2020. The number of attacks, deaths, and injuries, as well as primary weapons types, country where attacks occurred, and primary target types, were collated into a Microsoft Excel™ spreadsheet (Microsoft, Redmond Washington, USA) and analyzed.

A total of 19,320 attacks were recorded, resulting in 77,565 deaths and 52,986 injuries. Nigeria had the greatest number of attacks. Firearms were the most frequent weapons used, followed by explosives, unknown, and incendiary, with all others making up the remainder. Private citizens and property were the most frequently targeted entities, followed by general government facilities, police, business, military, diplomatic government facilities, and religious figures/institutions, with all other targets making up the remainder.

The majority of deaths from terrorism in SSA are the result of firearm attacks. Nigeria had the largest number of attacks and the highest number of killed and wounded. Private citizens and property are the most frequently targeted. Terrorism poses unique challenges to governments, populations, healthcare systems, and aid organizations. By understanding the impact and scope of terrorist activity in SSA, Counter-Terrorism Medicine (CTM) initiatives can be employed to improve healthcare outcomes.