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Intensification and poor management of industrial and urbanization activities increasingly threaten the health of the urban population. Taking into account the ecosystems and biodiversity into urban planning are among the key aspects of urban sustainable development. In the literature, key knowledge gaps remain for improving governance for urban sustainability and resilience. This paper examines and elaborates the challenges the cities, particularly in developing countries, face with regard to urban sustainable development. It considers the capital of Macedonia, Skopje, as a city where a chain of unsustainable policies during the last decade resulted in excessive air pollution and harm to the public health and to the economy. The analysis shows that determining appropriate governance responsive to sustainable urban development is a major challenge that developing cities face today. The article argues that there are trade-offs to be made between multilevel policy networks and a hierarchical structure, short-term and long-term perspective, human capacities of professionals and elected officials, political and community interests, community participation, and government control.

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