Episode 539: Geoff Dow on Babesiosis: Malaria Parallels, Tafenoquine (Arakoda), and New Clinical Trials for Chronic Tick-Borne Disease

Dr. Geoff Dow, CEO of 60 Degrees Pharmaceuticals and former malaria drug developer at Walter Reed, joins the Tick Boot Camp Podcast to unpack the science and strategy behind treating babesiosis.

Drawing parallels to malaria, Dow explains why tafenoquine (brand: Arakoda), FDA-approved for malaria prevention, is being studied for Babesia, how coinfections (Borrelia, Bartonella) complicate care, and why chronic illness needs a different clinical approach.

He previews an upcoming Mount Sinai trial for chronic babesiosis focused on fatigue outcomes and discusses real-world diagnostics using FDA-approved blood donor screening plus PCRs from Galaxy Diagnostics and Mayo Clinic.

The conversation also touches on prophylaxis concepts, immune dysregulation, and building a clearer path from anecdote to evidence for the tick-borne disease community.

Guest

Geoff Dow, BSc, MBA, PhD CEO & Board Member, 60 Degrees Pharmaceuticals Background: Biotechnology (Perth, Australia), PhD in malaria drug discovery, decade at Walter Reed Army Institute of Research, MBA in the U.S. Leads clinical programs exploring tafenoquine for babesiosis.

Key Topics & Takeaways

• Malaria ↔ Babesiosis Parallels: Both are red-blood-cell parasites; acute symptoms driven by red cell destruction. Similar drug targets justify testing some anti-malarials against Babesia.
• Why Tafenoquine (Arakoda): An 8-aminoquinoline that induces oxidative stress in RBCs; distinct mechanism from atovaquone + azithromycin combo (current standard for acute babesiosis), potentially useful for resistance management.
• Chronic vs. Acute Disease: Acute babesiosis in immunocompetent patients often responds to standard care; chronic illness remains under-defined and underserved.
• Coinfections Are Common: Many chronically ill patients present with Borrelia, Bartonella, and Babesia together; diagnostics and treatment need to acknowledge polymicrobial reality.
• Upcoming Clinical Trial (Mount Sinai):
• Population: Chronic babesiosis with disabling fatigue, plus Babesia symptoms (e.g., air hunger, anemia) and lab evidence in the last 12 months.
• Regimen: 4-day loading dose then 200 mg weekly of tafenoquine for 3 months.
• Outcomes: Patient-reported fatigue (quality-of-life) + monthly molecular testing (FDA blood donor test, Galaxy Diagnostics PCR, Mayo Clinic PCR) during treatment and 3 months post-therapy.
• Goals: Demonstrate symptom improvement, assess eradication signals, and validate accessible diagnostics against an FDA-accepted assay.
• Prophylaxis & Post-Exposure Ideas: Animal data suggest short-course tafenoquine can eradicate early Babesia; human prophylaxis trials face feasibility and regulatory hurdles.
• Diagnostics Gap: Need for standardized, sensitive tools to define chronic babesiosis and track response. This trial also serves as a real-world diagnostic comparison.
• Immune Dysregulation & IACI: Overlap among long COVID, ME/CFS, post-treatment Lyme—shared theme of immune dysregulation with possible persistent antigen stimulation.
• Safety Notes: G6PD deficiency is relevant to 8-aminoquinolines; established safety database exists for malaria prevention dosing—critical as studies expand to babesiosis.

Notable Quotes

• “You’ve got to put some lines in the sand—run the trial, collect data, and move the field forward.”
• “The best we can do for chronic disease starts with defining it—and validating the diagnostics we use to track it.”
• “8-aminoquinolines offer a different mechanism than current babesiosis standards—key for resistance and combinations.”

Resources Mentioned

• Arakoda (tafenoquine): FDA-approved for malaria prevention; under study for babesiosis.
• Diagnostics: FDA-approved Babesia blood donor screen; Galaxy Diagnostics PCR; Mayo Clinic PCR.
• Organizations & Events: ILADS, Global Lyme Alliance, tick-borne disease conferences.
• Research Partners: Mount Sinai (NYC), Tulane University (Bartonella/Borrelia collaboration).

Who Should Listen

• Patients with chronic Lyme or chronic babesiosis symptoms (fatigue, air hunger, anemia)
• Clinicians seeking updates on Babesia treatment research and diagnostics
• Caregivers and advocates tracking IACI and immune dysregulation science
• Researchers exploring antimalarial repurposing for tick-borne diseases

Call to Action

• Subscribe to Tick Boot Camp and share this episode with someone navigating chronic tick-borne illness.