Moves by rich countries to buy large quantities of monkeypox vaccine, while declining to share doses with Africa, could leave millions of people unprotected against a more dangerous version of the disease and risk continued spillovers of the virus into humans, public health officials are warning.

“The mistakes we saw during the Covid-19 pandemic are already being repeated,” said Dr Boghuma Kabisen Titanji, an assistant professor of medicine at Emory University. While rich countries have ordered millions of vaccines to stop monkeypox within their borders, none have announced plans to share doses with Africa, where a more lethal form of monkeypox is spreading than in the West.