Global research network needed if scientists are ever going to understand and prevent cleft palate

A global research network is needed if scientists are ever going to understand and prevent cleft palate, say experts at the first World Health Organization Collaborating Centre set up to develop such a structure.

Professor Bill Shaw, of The University of Manchester, says the complexity of craniofacial anomalies, like cleft lip and palate, means no one country, let alone institution, has the necessary expertise and resources to find all the answers to these distressing conditions.

His comments come as the University's School of Dentistry was designated a WHO Collaborating Centre for Research on the Treatment of Craniofacial Congenital Anomalies – the first such centre in the world – in recognition of the pioneering research carried out there into craniofacial disorders.

"Being designated a WHO Collaborative Centre is an honour and a challenge; it will be our role to promote and facilitate international collaboration and act in an advisory capacity to the World Health Organization," said Professor Shaw.

Although substantial progress has been made into the causes and treatment of craniofacial anomalies over the last few years, Professor Shaw says there is still a long way to go before they are fully understood.

"A child is born with a cleft somewhere in the world every two minutes and it has become clear just how complex these conditions are," he said.

"Our knowledge has improved but there is still uncertainty about the best form of treatment and the timing of that treatment, which is why a global, multi-centre approach is required.

"Recent discoveries confirm a genetic link in cleft and craniofacial anomalies but factors in the maternal environment may also act as a trigger to cause a fault in the development of the embryo."

The centre's 10-strong team, which includes staff from the University's Faculties of Medical and Human Sciences as well as Life Sciences, is already involved in a number of international collaborations.

"We are a clinical centre looking after about 80 babies born with cleft in the Northwest each year but we also organise international clinical trials, including one currently in Scandinavia," explained Professor Shaw.

"However, one of our main concerns is finding treatments that are affordable to developing countries where congenital anomalies will become a priority once the spread of infectious diseases is under control.

"Wealthier countries can send specialists out to these countries for short periods of time to perform as many operations as possible but it would be preferable for local doctors to be trained and establish dedicated clinics with sustainable funds."

One such clinic, indeed the largest in the world and one with which the University has close ties, is in the Brazilian city of Bauru.

"We have established an exchange programme with their staff where we share information, data and expertise," said Professor Shaw.

"This represents a model for the provision of high quality care and research in difficult economic circumstances that we will seek to develop on a global basis."