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The report highlights the critical role of zero-emission vehicle (ZEV) trucks in reducing greenhouse gas emissions and diesel-related health hazards, such as respiratory disease and premature death. While ZEV truck sales doubled in 2022 and model availability has increased, current trajectories are insufficient to meet climate targets. The authors advocate for a global ZEV truck sales target of at least 45% by 2030, citing California's Advanced Clean Fleet policy as a leading example of state-of-the-art regulation. The document emphasizes that sales standards must be paired with a comprehensive policy portfolio including charging infrastructure, consumer incentives, and equity considerations to ensure a successful transition.

The report evaluates U.S. school bus emissions, finding that older diesel buses release significantly more soot than modern alternatives, posing health risks to children. It grades states on soot emissions, cleanup programs, and smog-forming pollution, noting wide performance gaps. The authors recommend a strategy of 'the five Rs'—retrofitting, refueling, replacement, repair, and reduced idling—and call for strengthened federal standards and increased funding to modernize fleets.