The Invisible Killer: Georgia’s Death Data Gap

Unspecified causes of death remain the second leading cause of mortality in Georgia, surpassing cancer. While cardiovascular disease is the primary killer, nearly one in five people die without an officially identified cause.

According to the latest available data from the National Statistics Office of Georgia (2024), cardiovascular diseases remain the leading cause of death, accounting for 41.3% of all recorded deaths. This is followed by a substantial 21.7% of deaths classified as "undefined."

A breakdown of Georgia’s 9,558 unspecified deaths in 2024 reveals a distinct gender crossover. While cases remain low under age 35, men consistently outnumber women in mid-life, peaking between ages 60 and 74. However, this trend dramatically reverses in the oldest demographic: among those aged 85 and over, female cases spike sharply to 1,934, vastly outnumbering the 795 cases recorded for men.

For at least 10 years, these undefined deaths in Georgia  have frequently outranked cancer as the second leading killer.

When adjusted per 100,000 residents, the data shows large regional differences in undefined deaths across Georgia. Shida Kartli records the highest rate at 537 deaths, followed closely by Tbilisi at 469 and Kakheti at 432. Meanwhile, Adjara records the lowest rate at 67. This creates a clear gap, with the rate in Shida Kartli being eight times higher than the rate in Adjara. 

While the NCDC openly admits that high numbers of "undefined" deaths are driven by this poor data quality – specifically blaming sloppy medical records, inconsistent coding by doctors, and a lack of paperwork when people die outside of a facility – they argue that this is normal for a developing country. To justify the gap, the center points to World Health Organization (WHO) benchmarks. They note in an official response that while wealthy nations keep vague death codes down to 5% or 10%, middle - and low - income countries frequently see those numbers climb to 20% or 30% due to missing clinical documentation.

However, Georgia's own history proves that these high numbers are not inevitable. Between 2018 and 2021, the country successfully bucked this trend, cutting undefined deaths nearly in half.

Amiran Gamkrelidze, the former head of the National Center for Disease Control and Public Health attributes that previous decline to his team’s implementation of "Verbal Autopsies" during his tenure. By interviewing families and medical personnel, the NCDC was able to determine likely causes of death when records were missing.

Since 2022, undefined death numbers have climbed back toward 22%. Gamkrelidze notes that since leaving office, he cannot account for why these numbers have surged again, as he no longer oversees the agency’s data collection and investigative processes.

The agency’s defense shows a major loophole in how they handle these numbers. In their written letter, the NCDC admits that "Verbal Autopsies – interviewing families and doctors to find out why someone die – successfully cut undefined deaths from a massive 50% in 2010 down to its lowest points. However, they talk about this active fieldwork entirely as a thing of the past. When describing what they do today, the agency shifts to vague, bureaucratic language, saying only that they "monitor data" and "consult" hospitals on paperwork.

With undefined deaths once again making it the country's second leading killer, it remains unclear how the state has allowed the data gap to widen back to 21.7% in 2024. When we don't know why people are dying, we don't know how to save them. Having "Unknown Causes" as the #2 killer means the state can't effectively fight an invisible enemy. Medical statistics are needed so the state's response to the challenges that exist in the country is planned correctly.

NCDC_RESPONCE.pdf

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