The Declaration of Istanbul was created at the Istanbul Summit on Organ Trafficking and Transplant Tourism held from 30 April to 1 May 2008 in Istanbul, Turkey. The Declaration clarifies the issues of transplant tourism, trafficking and commercialism and provides ethical guidelines for practice in organ donation and transplantation. Since the creation of the declaration, over 100 countries have endorsed the principles. Some nations have subsequently strengthened their laws against commercial organ trade, including China, Israel, the Philippines, and Pakistan.