This document intends to be a snapshot of the two-day COC 2026 conference where collective learnings, experiences, and perspectives of cleft professionals were united by a shared commitment to advancing comprehensive cleft care across Madagascar. Weaving together surgery, speech, and coordination, the report captures highlights from the conference and how stronger multidisciplinary collaboration, locally driven solutions, and shared expertise can shape improved outcomes for patients, as well as a more sustainable future for cleft care in Madagascar.