In recent decades, the rapid growth of road transport in the European Region, while supporting economic development and integration, has harmed health and the environment through congestion, road traffic crashes, air and noise pollution, and contributing to sedentary lifestyles and emissions of greenhouse gases. The health and environmental consequences of transport affect most of the population, not just transport users.

Growing concern and commitment to strengthening the integration of environment and health issues into transport policies in European countries led to the establishment of a series of policy frameworks to help them pursue more sustainable and healthy transport. In 2002, these converged in the Transport, Health and Environment Pan-European Programme (THE PEP), jointly managed by the WHO Regional Office for Europe and the United Nations Economic Commission for Europe (UNECE).

The global financial crisis is challenging governments committed to implementing international agreements to reduce greenhouse-gas emissions. At the High-level Meeting on Transport, Health and Environment in Amsterdam, the Netherlands, policy-makers from ministries of transport, health and the environment across Europe are examining how innovative transport policies can create employment and economic opportunities for a healthier society. Hosted by the Government of the Netherlands, the High-level Meeting is taking place on 22–23 January 2009 and was organized by the WHO Regional Office for Europe and the United Nations Economic Commission for Europe (UNECE).

Transport contributes up to 10% of gross domestic product (GDP) and provides jobs and access to leisure activities and livelihoods. Its negative effects, however, include pollution, congestion, landscape degradation and contributions to climate change, as well as morbidity and mortality; the costs of these effects, estimated at about 8% of GDP, threaten to offset the gains. Cardiovascular diseases and obesity from physical inactivity, respiratory diseases from air pollution and premature deaths and life-long disabilities from road traffic crashes represent the largest part of the external costs of transport.