Peter Freeman and Kavita Mathur
IEG Working Paper 2008/2
World Bank
2008
The transport sector plays a crucial, overarching role in the global economy: it facilitates access to jobs, education, health care, markets as well as for social and leisure activities. Yet, transport also has detrimental impacts on the environment and on human health, and this can result in conflicts in the formulation and application of transport policy. While traffic injuries, fatalities, and annoyance from transport-related noise have long been identified as negative externalities, there has been increasing evidence in the past decade of direct effects of transport-induced air pollutants on mortality and respiratory disease. The adverse impacts of transport on health are worse in developing countries than in industrial countries, as resources are more limited, regulatory controls are often inadequate and poorly enforced, the transport fleet tends to be older and technically more inefficient, the population is generally less educated, and transportrelated law enforcement is frequently inadequate.
This paper reviews the contribution of the World Bank’s transport lending portfolio to health outcomes, as background for the Independent Evaluation Group’s (IEG) evaluation of the Bank’s support for health, nutrition and population(HNP). Over the past decade (FY97-06), the World Bank committed nearly $28 billion to 229 new transport projects managed by the Transport Sector Board (TSB). Specifically, the paper reviews the extent to which these projects: cite potential health benefits or risks in design documents; include specific objectives with respect to improving health outcomes or mitigating health risks; propose environmental improvements that are likely to provide health benefits; target transport services and both health and behavioral outcomes to the poor; and plans to collect evidence on changes in health outcomes as a result of transport interventions. For completed projects, it assesses the extent to which expected health
benefits or objectives have been achieved.
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