From Prof Jeffrey D. Sachs.

Sir, Profs Stuckler, King and McKee (Letters, January 22) claim that they "provide robust evidence that rapid privatisation increased unemployment, reduced access to healthcare, formerly provided by state-owned companies, and depleted the state budget". In fact, their Lancet paper contains no such evidence. What it actually says is that "future studies should examine whether the disruption of these social services as a result of privatisation was an important mechanism of increased mortality". A call for "future studies" is not the same as "robust evidence".

They note that "there is a wealth of evidence that these additional deaths were substantially due to changes in hazardous drinking". Yet they offer no evidence that the changes in hazardous drinking were caused by mass privatisation. The surge of alcohol-related deaths as of the early 1990s occurred upon the reversal of Mikhail Gorbachev's abortive anti-alcohol campaign. Poor diets also contributed to cardiovascular disease and the mortality surge when the Soviet health system collapsed along with the Soviet Union.

Their argument that Poland succeeded because the government "did not follow my advice" is mistaken. I was awarded the Commander's Cross of the Order of Merit of the Republic of Poland in recognition of my contributions to Poland's successful reforms. Poland was the exemplar of "shock therapy", meaning a rapid and successful transformation to a market economy. I championed a variety of privatisation methods in Poland.

Their claim that from 1992 to 1994 Russia "reduced the money supply (stabilisation)" is an inexplicable error. Russia's money supply soared after 1991, unleashing a catastrophic inflation of more than 300 per cent in 1994. Russia's failure to stabilise resulted from inappropriate monetary policies coupled with the west's failure to provide financial support for stabilisation.

Faster and more consequent reforms combined with timely western financing would have been much less painful for Russia. That is why I argued day and night during 1992-93 for the west to help cushion the heavy blows hitting the former Soviet Union; but alas, with little western response.

Jeffrey D. Sachs,

Columbia University,

New York, NY, US