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).