Tuberculosis (TB) is a global health emergency killing more people than any single infectious disease. More than 10 million individuals around the world develop TB disease and close to a million and a half die every year from TB. Tuberculosis in mammals is caused mainly by a group of bacteria collectively termed the Mycobacterium tuberculosis complex (MTbc). Even though the MTbc seems to be genomically monomorphic, individual members have adapted to distinct host, with occasional cross species infections. Human TB is caused mainly by M. tuberculosis sensu stricto and M. africanum which have further been subdivided into lineages, that display a phylogeographic structure. This means that distinct lineages are more adaptable to infect specific human populations. This is the case of the lineages of M. africanum which have a special preference for West Africans. My research team has over the past two decades, conducted genomic epidemiological studies to explain the restriction of M africanum to West-Africa and to understand the transmission dynamics of MTBC in Ghana including impact of risk factors such as drug resistance, lineages and co-morbidity such as diabetes and HIV on the TB epidemic.  My talk will centre on my work in the context of other studies conducted in West-Africa.