Pakistan and Pakistan-U.S. Relations 
May 22, 2023 
As of May 2023, Pakistan is in what some observers have called a “polycrisis,” with serious 
political instability, an economic balance-of-payments crisis, renewed domestic security and 
K. Alan Kronstadt 
terrorism threats, reduced diplomatic influence, and other challenges, including those related to 
Specialist in South Asian 
energy and climate. The country is also the site of serious and ongoing human rights abuses, 
Affairs 
some formally prohibited by the state, but some also sanctioned by the state.  
  
Since 2001, U.S. policy has broadly sought to encourage the development of a more stable, 
 
democratic, and prosperous Pakistan that actively combats religious militancy. Pakistan is a 
nuclear-armed country twice the size of California, home to more than 200 million people, as well as numerous Islamist 
terrorist groups, and situated in a strategically vital region of South Asia and the Indian Ocean coastline. The Biden 
Administration did not mention Pakistan in its Indo-Pacific or national security strategies. Pakistan’s increasingly close ties 
with U.S. competitor China, its decades-long rivalry and conflict with U.S. strategic partner India, and its troubled relations 
with the Taliban government in Afghanistan are likely to be among the many factors influencing the likelihood and ability of 
the United States to attain its foreign and regional policy goals, including future levels of regional stability and security. 
Legislation and congressional oversight has and can continue to affect the course of U.S.-Pakistan relations. Congress can set 
levels of U.S. foreign assistance, consider whether or not to facilitate expanded bilateral trade and investment, and whether or 
not to assist efforts to strengthen Pakistan’s democratic institutions and rule of law, stabilize its economy, secure its nuclear 
weapons arsenal, and improve its human rights record. 
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Pakistan and Pakistan-U.S. Relations 
 
Contents 
Overview ......................................................................................................................................... 1 
Pakistan-U.S. Relations ................................................................................................................... 1 
Bilateral Security Relations ....................................................................................................... 2 
U.S. Foreign Assistance ............................................................................................................ 3 
Pakistan’s Political Instability ......................................................................................................... 3 
Pakistan’s Economic Crisis ............................................................................................................. 4 
Pakistan’s Energy and Climate Issues ............................................................................................. 5 
Pakistan’s Domestic Security Setting .............................................................................................. 6 
Pakistan’s Nuclear Weapons Arsenal and Security.......................................................................... 6 
Pakistan’s Human Rights Issues ...................................................................................................... 7 
Other Foreign Relations of Pakistan ................................................................................................ 7 
Pakistan-China Relations and CPEC......................................................................................... 7 
Pakistan-India Relations and Kashmir ...................................................................................... 8 
Pakistan-Afghanistan Relations ................................................................................................ 9 
Pakistan and the Russia-Ukraine Conflict ................................................................................. 9 
Issues Facing Congress ................................................................................................................. 10 
 
Figures 
Figure 1. Map of Pakistan ............................................................................................................. 13 
  
Tables 
Table 1. Direct Overt U.S. Aid Appropriations for and  Military Reimbursements to 
Pakistan, FY2002-FY2024 .......................................................................................................... 11 
  
Contacts 
Author Information ........................................................................................................................ 13 
 
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Pakistan and Pakistan-U.S. Relations 
 
Overview 
Since 2001, U.S. policy has broadly sought to encourage the development of a more stable, 
democratic, and prosperous Pakistan that actively combats religious militancy. Biden 
Administration officials continue to assess that the United States has interests in engaging with 
Pakistan on terrorism and efforts to foster regional stability, as well as on nuclear proliferation, 
Pakistan-India tensions and conflict, democratization and human rights protection, and economic 
development.1 Pakistan is today in what some observers have called a “polycrisis,” with serious 
political challenges, most recently exemplified by the May 9 arrest of former Prime Minister 
Imran Khan; a weak economy battered by massive flooding in mid-2022 and on the brink of 
defaulting on international debt obligations; militancy and deteriorating domestic security; and 
notably less diplomatic influence following the 2021 U.S. military withdrawal from Afghanistan.  
Pakistan-U.S. Relations 
Two significant developments have qualitatively shifted the security- and terrorism-oriented 
framework in which U.S.-Pakistan relations took place from 2001 to 2021: increasing enmity 
between the United States and China, Pakistan’s key ally, and the U.S. military withdrawal from 
Afghanistan. The Biden Administration’s fulsome engagement with the Quadrilateral Security 
Dialogue (or “Quad,” along with India, Japan, and Australia), and central focus on countering 
China—combined with a reduction in U.S. government attention to Afghanistan—has led some 
Pakistani leaders to express anxiety that their country’s salience to Washington has been 
diminished and undermined in part by perceptions that Islamabad is falling into Beijing’s 
geopolitical “camp.”2 
Pakistani officials and some independent analysts have called for a “reset” of bilateral ties with 
the Biden Administration to replace a long-dominant security orientation with more 
comprehensive relations. They conceive this as a focus on “geoeconomics” in which Pakistan 
would pursue regional integration toward a collective goal of sustainable development. Political 
and business leaders in Pakistan present the country as a prospective economic partner of the 
United States based on development and investment, with engagement in key sectors such as 
information technology, agriculture, health, energy, and climate change. The country is rapidly 
digitizing, has a large, entrepreneurial middle-class that includes hundreds of thousands of tech 
professionals—many of them English-speaking—fueling Pakistani aspirations to become a new 
regional tech hub.3  
The Biden Administration has as of yet shown few signs that a broad reset is in store, and 
President Joe Biden has not directly engaged a Pakistani prime minister since taking office.4 A 
group of prominent D.C.-based analysts recommends “A modest, pragmatic relationship between 
 
1 See the State Department’s January 20, 2021, release at https://www.state.gov/u-s-relations-with-pakistan. 
2 CRS communication with Pakistan’s Embassy in the United States, May 2021; “Shehbaz Sharif Reiterates Desire to 
Rebuild Pak-US Friendship,” 
Radio Pakistan, September 29, 2022. 
3 See the November 3, 2022, remarks by Pakistan’s Ambassador to the United States, Masood Khan, at 
https://tinyurl.com/5ndsyvae. 
4 Madiha Afzal, “The Biden Administration’s Two-Track Pakistan Policy Misses the Mark,” Brookings Institution, 
March 2, 2023. 
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the U.S. and Pakistan, one not based on exaggerated expectations on both sides ...”5 Public 
opinion surveys suggest that anti-Americanism remains widespread among Pakistanis.6  
Nevertheless, 2022 marked the 75th anniversary of U.S.-Pakistan relations, and some substantive 
bilateral reengagement has taken place over the past year, including the July 2022 launch of a 
U.S.-Pakistan Health Dialogue to deepen health sector cooperation;7 the ninth meeting under the 
U.S.-Pakistan Trade and Investment Framework in February 2023 (after an eight-year hiatus);8 
and a March session of the U.S.-Pakistan Energy Security Dialogue.9 
Bilateral Security Relations 
The scope of U.S.-Pakistan security cooperation was already diminishing before the August 2021 
U.S. military and diplomatic withdrawal from Afghanistan. Circumscribed bilateral cooperation 
continues with a central focus on counterterrorism and regional stability.10 High-level military-to-
military engagements have included the Commander of the U.S. Central Command’s two visits to 
Pakistan in 2022;11 the U.S. Secretary of Defense hosting Pakistan’s Chief of Army Staff at the 
Pentagon in October 2022;12 and a session of the U.S.-Pakistan Counterterrorism Dialogue in 
March 2023.13 Security-related assistance to Pakistan in recent years has been limited to funding 
for International Narcotics Control and Law Enforcement (averaging about $26 million annually 
over the past five years, mainly for border security) and, since their resumption in FY2021, 
International Military Education and Training programs funded at $3 million-$4 million per year 
(see
 Table 1).14 
In July 2022, a U.S. drone strike killed Al Qaeda leader Ayman al-Zawahri in Kabul, Afghanistan. 
Afghan Taliban leaders immediately accused Pakistan of providing airspace for the operation. 
While the Islamabad government publicly denied playing any role, many analysts believe the 
strike could not have taken place without Pakistan’s foreknowledge and likely assent.15 
In September 2022, the Biden Administration announced that it would provide a sustainment 
package for Pakistan’s F-16 combat aircraft fleet at a potential cost to Pakistan of up to $450 
million.16 India’s government strongly protested the announcement, leading the U.S. Secretary of 
State to publicly state that, “These are not new planes, new systems, new weapons,” and contend 
that the United States has an obligation to sustain the military equipment it exports, and that this 
 
5 Husain Haqqani, “US Reengagement with Pakistan: Ideas for Reviving an Important Relationship—A Report of the 
Pakistan Study Group,” Hudson Institute, November 17, 2022. 
6 See, for example, Gallup Pakistan’s April 2022 findings at https://www.gallup.com.pk/post/33081. 
7 See the State Department’s July 25, 2022, release at https://tinyurl.com/3smrthzx. 
8 See the February 23, 2023, Joint Statement at https://tinyurl.com/ms7a7vn9. 
9 “Joint Statement on U.S.-Pakistan Energy Security Dialogue,” U.S. Embassy Islamabad, March 15, 2023. 
10 In September 2022, Secretary of State Antony Blinken hosted his Pakistani counterpart in Washington and 
commented that the two countries continue to “work closely” on countering terrorism, in particular threats emanating 
from Afghanistan (see the State Department’s September 26, 2022, transcript at https://tinyurl.com/25fj2r8w). 
11 See CENTCOM’s August 20, 2022, release at https://tinyurl.com/ykdu82y6, and its December 16, 2022, release at 
https://tinyurl.com/358n4y4f. 
12 See the Defense Department’s October 4, 2022, release at https://tinyurl.com/bdzh5b6m. 
13 See the U.S. Embassy Islamabad’s March 7, 2023, release at https://tinyurl.com/prspbxh6. 
14 Aid amounts calculated by CRS using U.S. government data. 
15 “Al-Zawahiri’s Killing Raises Tensions Between Pakistan and Afghanistan,” Jamestown Foundation 
Terrorism 
Monitor, October 21, 2022. 
16 See the U.S. Defense Security Cooperation Agency’s September 7, 2022, release at https://tinyurl.com/24znpsx9. 
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effort would bolster Pakistan’s “capability to deal with terrorist threats emanating from Pakistan 
or from the region.”17 
U.S. Foreign Assistance 
From 2001 until the second Obama Administration, Pakistan was among the leading recipients of 
U.S. foreign assistance, with Congress appropriating $11 billion in economic, development, and 
humanitarian aid, and nearly $8 billion in security-related aid for FY2002-FY2016. Pakistan also 
received about $14.6 billion in Pentagon military reimbursements during this period.18 From 
FY2017 on, the Trump Administration requested and Congress appropriated significantly reduced 
aid amounts (reaching a two-decade nadir of $87 million in FY2021) and, in 2018, the 
Administration initiated a broad, terrorism-related security aid suspension that has largely 
continued to date. The Biden Administration requested, and Congress has appropriated, modestly 
increased economic and development assistance amounts for FY2022 and FY2023—up 25% and 
6% year-on-year, respectively. The United States has also committed more than $200 million to 
flood relief, disaster resilience, and food security aid for Pakistan since mid-2022. The 
Administration’s total aid request for FY2024 stands at $173 million (see
 Table 1).19  
Pakistan’s Political Instability  
Elections to seat Pakistan’s 15th National Assembly (NA, the lower house of its bicameral 
legislature) and the country’s four provincial assemblies took place in July 2018, marking the 
country’s second-ever democratic transfer of power. The relatively young Pakistan Tehreek-e-
Insaf (PTI or Movement for Justice) party swept a large plurality of NA seats, and party founder 
and leader Imran Khan became prime minister. However, in March 2022, opposition parties in the 
NA moved a no-confidence motion against him, accusing him of poor governance and economic 
mismanagement. This sparked a month-long crisis that resulted in Khan’s removal from office in 
April 2022 and the seating of a new coalition government under Pakistan Muslim League-Nawaz 
party leader and former Punjab chief minister Shehbaz Sharif (se
e Figure 1).20  
Khan and his party, having reportedly lost the support of Pakistan’s powerful military that was 
seen to have facilitated their 2018 victory, spent the ensuing year demanding early national and 
provincial elections.21 Khan has also vigorously denounced his removal from office, variously 
blaming it (without providing evidence) on alleged machinations by the U.S. government and/or 
Pakistan Army leadership, both current and former. Khan, who is able to mobilize strong political 
support and “street power,” faces scores of corruption-related and other criminal cases against 
 
17 “India Registers Strong Protest with U.S. over Pakistan F-16 Package,” 
Times of India (Delhi), September 11, 2022; 
see the State Department’s September 27, 2022, transcript at https://tinyurl.com/2p8n3zfy.  
18 Starting in 2007, Congress imposed increasingly broad and stringent conditions on all nonhumanitarian aid transfers 
and military reimbursements to Pakistan. From 2008 to 2016, U.S. Presidents exercised authorities to waive those 
conditions in the interests of U.S. national security, even as annual aid and reimbursement levels steadily declined from 
an FY2010 peak total of about $4.5 billion to $1.24 billion in FY2016, the year that Pakistan last received military 
reimbursements. Congress has not appropriated foreign military financing for Pakistan since FY2017. Aid amounts 
calculated by CRS using U.S. government data. 
19 For the most recent congressional certification requirements for U.S. assistance to Pakistan, see Section 7044(d) of 
the Consolidated Appropriations Act, 2003 (P.L. 117-328). 
20 See also CRS In Focus IF10359, 
Pakistan’s Domestic Political Setting, by K. Alan Kronstadt. 
21 Under Pakistan’s Constitution, elections must be held no later than October 2023. In early April 2023, Pakistan’s 
Supreme Court ordered that Punjab provincial elections be held on May 14, but the Sharif government and the Election 
Commission of Pakistan defied that order in a jurisdictional dispute, possibly with the Army’s blessing (“CJP Bandial 
Still Hopeful of Talks Ending Elections Stalemate,” 
Dawn (Karachi), May 15, 2023). 
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him. His unprecedented public criticism of the country’s security establishment—including 
accusing a senior intelligence officer of orchestrating a November assassination attempt on him—
may have contributed to his arrest in Islamabad on May 9, sparking nationwide unrest. The 
Supreme Court found the arrest “unlawful” and ordered that the former prime minister 
immediately be released, which occurred on May 11. Khan still faces potential disqualification 
from political office. The army was mobilized in two provinces in response to protests by PTI 
activists, raising fears of large-scale civil conflict in a country already reeling from multiple 
crises.22 The Biden Administration has continued to publicly support Pakistan’s democratic 
institutions and rule of law while taking no position on the country’s domestic political disputes.23 
Pakistan’s Economic Crisis 
Pakistan remains a poor country with high rates of inflation and unemployment, and sometimes 
acute food, water, and energy shortages. Annual economic growth, averaging 4-6% during the 
2010s, dipped to -0.5% in 2020. High interest rates and a weak rupee continue to hamper growth. 
Consumer price inflation soared to a record 36.4% in April 2023.24 According to the World Bank, 
“Pakistan is experiencing severe economic challenges reflecting long-standing structural 
weaknesses,” with major stresses arising from low foreign reserves, a depreciating currency, and 
high inflation. Real GDP growth is expected to slow to 0.4 percent in FY2023, “reflecting 
corrective tighter fiscal policy, flood impacts, high inflation, high energy prices and import 
controls.”25 Corruption remains a major obstacle to Pakistan’s economic development, and the 
country has one of the world’s lowest tax-to-GDP ratios.26  
In 2022, the United States imported about $6 billion worth of goods from Pakistan (mainly 
textiles and clothing), and Pakistan imported U.S. goods valued at $3.2 billion (mostly cotton, 
oilseeds, and fruit). The United States is by far Pakistan’s largest external market, and China is by 
far Pakistan’s largest external supplier.27 Pakistan remains on the U.S. Trade Representative’s 
Special 301 Watch List in 2023 due to “serious concerns” about its intellectual property 
protection and enforcement, with counterfeiting and piracy said to be widespread.28  
For five years Pakistan’s government has teetered on the edge of a debt and balance of payments 
crisis. The World Bank, China, Saudi Arabia, and the United Arab Emirates each have provided 
multi-billion-dollar loans. In 2019, the government conceded to accepting a three-year, $6 billion 
bailout from the International Monetary Fund (IMF), adding to the $5.8 billion Pakistan already 
owed to that body. It is Pakistan’s 13th such loan in 32 years and requires structural economic 
 
22 “SC Terms Imran’s Arrest ‘Unlawful,’ Directs Him to Appear Before IHC Tomorrow,” 
Dawn (Karachi), May 11, 
2023. 
23 When asked about recent political instability in Pakistan in mid-May, a State Department spokesman said, “[We] 
don’t have a position on one candidate or one political party versus another. What our interest is is a safe and secure, 
prosperous Pakistan. That is in the interest of the U.S.-Pakistan relations, and we call for the respect of democratic 
principles and the rule of law around the world” (see the Department’s May 11, 2023, transcript at https://tinyurl.com/
3e4my65h). 
24 “Global Inflation Tracker,” 
Financial Times (London), May 10, 2023. 
25 See https://www.worldbank.org/en/country/pakistan/overview#1. 
26 Berlin-based Transparency International’s 
Corruption Perceptions Index 2022 ranks Pakistan 140th of 180 countries, 
with a declining score for five consecutive years (see https://tinyurl.com/4hd6uz85; “Tax Ratio Drops to 4.4pc in First 
Half,” 
Dawn (Karachi), February 9, 2023). 
27 Bilateral trade statistics at https://www.census.gov/foreign-trade/balance/c5350.html. According to the World Bank, 
the United States accounted for more than 18% of all Pakistan goods exports in 2020, while China accounted for more 
than 27% of Pakistan’s total imports that year (see https://wits.worldbank.org/CountrySnapshot/en/PAK). 
28 See https://ustr.gov/sites/default/files/2023-04/2023%20Special%20301%20Report.pdf. 
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reform, reduction of the budget deficit, controlling inflation, and expansion of the tax base.29 The 
IMF authorized a $1.2 billion tranche for Pakistan in July 2022, but Islamabad has thus far not 
persuaded the IMF that the country can meet and sustain requisite austerity measures. Many 
analysts expect Pakistan to go into default by 2024, and Imran Khan’s May 2023 arrest likely 
decreases the chance of an IMF bailout this year.30  
Pakistan’s Energy and Climate Issues 
The bulk of Pakistan’s primary energy supply comes from oil and natural gas. Hydropower is the 
leading source of renewable energy, while the wind and solar sectors are slowly growing. More 
than 40 million Pakistanis, roughly one-fifth of the population, remain without access to 
electricity, and half lack access to clean cooking facilities.31 Ongoing reliance on oil and gas 
raises difficulties due to limited reserves and exploration activity, and poor refining capacity. 
Power supply is regularly outstripped by demand, leading to periodic and often widespread 
blackouts. A water crisis is deepening, and heat waves are highly damaging to Pakistan’s 
economy, especially in the agriculture and informal sectors.32  
Summer 2022 floods in Pakistan created a humanitarian crisis and raised environmental and 
governance issues. Flooding affected one-third of the country’s land area and some 33 million 
people; more than 1,700 died. The Islamabad government estimates the cost of flood damage at 
$30 billion.33 The country suffers from environmental challenges that potentially worsen natural 
disasters, including flooding. A 2021 World Bank 
Vulnerability Assessment found that “Pakistan 
faces some of the highest disaster risk levels in the world.”34 Yale University’s 2022 
Environmental Performance Index ranked Pakistan 176th of 180 countries, finding especially poor 
performance in the categories of health and climate policy.35 
Some experts assess that Pakistan is among those countries most vulnerable to climate change. A 
German-based think tank’s report on climate change identified Pakistan as the world’s 8th-most-
affected country, suffering nearly $3.8 billion in related economic losses for the period 2000-
2019.36 At the November 2022 COP27 Climate Conference in Egypt, Pakistani officials took a 
leading role in apparently successful developing country efforts to elicit “loss and damage” 
financial compensation from developed countries.37 
 
29 See the April 8, 2021, IMF Pakistan FAQ at https://www.imf.org/en/Countries/PAK/FAQ. 
30 “Pakistan Moving Towards Debt Default by 2024,” Economist Intelligence Unit (London), April 20, 2023; “Pakistan 
Default Risk Grows as Khan Arrest May Delay IMF Deal,” Bloomberg, May 10, 2023. 
31 See the International Energy Agency’s Pakistan page at https://www.iea.org/countries/pakistan. 
32 Pakistan Ministry of Planning, Development, and Special Initiatives, 
Pakistan Energy Outlook Report (2021-2030), 
March 2022; “Facing ‘Severe’ Energy Crisis, Pakistan Reverts to Five-Day Work Week,” Reuters, June 7, 2022; 
“‘Perfect Climate Storm’: Pakistan Reels from Extreme Heat,” 
Al Jazeera (Doha), May 21, 2022. 
33 See CRS In Focus IF12211, 
Pakistan’s 2022 Floods and Implications for U.S. Interests, by K. Alan Kronstadt and 
Rhoda Margesson. At a U.N.-sponsored, January 2023 “Conference on Climate Resilient Pakistan,” international 
donors committed over $9 billion to help Pakistan’s flood recovery, exceeding Islamabad’s external financing goals 
(see https://tinyurl.com/bdzxnxud). 
34 See https://climateknowledgeportal.worldbank.org/country/pakistan/vulnerability. 
35 See https://epi.yale.edu/epi-results/2022/country/pak. 
36 See https://www.germanwatch.org/en/19777. 
37 “In a First, Rich Countries Agree to Pay for Climate Damages in Poor Nations,” 
New York Times, November 17, 
2022. 
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Pakistan’s Domestic Security Setting 
Pakistan remains a haven for numerous Islamist extremist and terrorist groups, and Pakistani 
governments have tolerated and even supported some of these as proxies in Islamabad’s historical 
tensions and conflicts with its neighbors, according to U.S. government reporting.38 Twelve 
Islamist militant groups operating on or from Pakistani territory are designated as Foreign 
Terrorist Organizations (FTOs) under U.S. law. They fall into five broad categories: globally-
oriented (primarily Al Qaeda and the Islamic State); India- and Kashmir-oriented; Afghanistan-
oriented; sectarian; and domestically-oriented. After 2014, Pakistan saw a dramatic reduction in 
rates of domestic militancy, in large part due to intensive state security efforts and military 
operations in western border regions. However, U.S. and Pakistani officials have since 2021 
identified a local resurgence of the Pakistani Taliban (TTP, see below), as well as new recruitment 
by Islamic State Khorasan province (IS-K), as key threats. A long-simmering separatist conflict in 
Baluchistan also persists (see
 Figure 1).39  
In 2018, the United States joined the United Kingdom in urging other members of the Paris-
based, intergovernmental Financial Action Task Force (FATF) to return Pakistan to its list of 
countries that show “strategic deficiencies” in combating money laundering and terrorism 
financing. FATF then added Pakistan to this “gray list,” damaging Pakistan’s international 
financial standing. In October 2022, after years of periodic assessments, FATF determined that 
Pakistan had made sufficient progress on all 34 “action items,” and it removed Pakistan from the 
“gray list.”40 
Pakistan’s Nuclear Weapons Arsenal and Security 
According to public sources, “Pakistan continues to expand its nuclear arsenal with more 
warheads, more delivery systems, and a growing fissile materials production industry.”41 The 
country currently possesses an estimated 160-165 warheads, along with delivery systems capable 
of reaching at least 2,000 kilometers, enough to target all of India’s territory. Pakistan’s 
development of short-range, low-yield nuclear-armed missiles since 2015—ostensibly a response 
to India’s purported “cold start” doctrine of rapid preemptive strikes with conventional forces—
has raised fears among some analysts about negative effects on crisis stability in the event of open 
warfare between Pakistan and India.42 Pakistan has neither acceded to the nuclear 
Nonproliferation Treaty nor accepted comprehensive International Atomic Energy Agency 
safeguards. The security of Pakistan’s nuclear arsenal, materials, and technologies continues to be 
a top-tier U.S. concern. The illicit nuclear proliferation network overseen by Pakistani 
metallurgist A.Q. Khan was disrupted after its exposure in 2004, but analysts warn that parts of 
the network may still be intact.43 U.S. officials express confidence in Pakistan’s nuclear security 
 
38 See the State Department’s 
Country Reports on Terrorism 2019 at https://go.usa.gov/xHh4c. See also CRS In Focus 
IF11934, 
Terrorist and Other Militant Groups in Pakistan, by K. Alan Kronstadt.  
39 Husain Haqqani, “The Deep Roots of Pakistan’s Terrorism Crisis,” 
Foreign Policy, March 3, 2023. 
40 See FATF’s October 2022 release at https://tinyurl.com/4hzfkdxw. 
41 Hans Kristensen and Matt Korda, “Nuclear Notebook: How Many Nuclear Weapons Does Pakistan Have in 2021?,”
 
Bulletin of the Atomic Scientists September 7, 2021. 
42 See also Arms Control Association, “Nuclear Weapons: Who Has What at a Glance,” January 2022; “Enhancing 
Strategic Stability in Southern Asia: USIP Senior Study Group Final Report,” U.S. Institute of Peace, March 17, 2022. 
43 See, for example, Aaron Arnold and Darya Dolzikova, “AQ Khan Is Dead—Long Live the Proliferation Network,” 
Royal United Services Institute (London), October 15, 2021. 
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even as there is ongoing concern that Pakistan’s nuclear materials, know-how, or technologies 
remain prone to unauthorized leakage.44  
Pakistan’s Human Rights Issues 
Pakistan is identified as being the site of numerous reported human rights abuses, some of them 
perpetrated and/or sanctioned by the state. According to the State Department’s 
2022 Country 
Reports on Human Rights Practices, significant human rights issues are serious and extensive. 
The Department contends that, “There was a lack of government accountability, and abuses, 
including corruption and misconduct by security services, often went unpunished, fostering a 
culture of impunity among perpetrators.” The report calls law enforcement efforts against human 
trafficking “inadequate,” and says that forced and bonded labor “was widespread and common in 
several industries across the country.”45 International watchdog groups often rank Pakistan among 
the world’s most dangerous countries for both journalists and women.46  
The State Department’s 
2022 Report on International Religious Freedom lists numerous reports 
of restrictions, in particular those related to Pakistan’s harsh blasphemy laws and its persecution 
of Ahmadi Muslims.47 The most recent annual report of the U.S. Commission on International 
Religious Freedom similarly contends that Pakistan’s religious freedom conditions continued to 
deteriorate in 2022, and it (again) recommends that Pakistan be re-designated a “Country of 
Particular Concern” (CPC) under the 1998 International Religious Freedom Act “for engaging in 
systematic, ongoing, and egregious violations of religious freedom.”48 In 2018, the Trump 
Administration designated Pakistan as a CPC for the first time; the Biden Administration issued 
the fourth re-designation in December 2022.49 
Other Foreign Relations of Pakistan 
Pakistan-China Relations and CPEC 
Pakistan and China have enjoyed what both call an “all-weather friendship” for more than four 
decades, and both countries retain longstanding rivalries with India. Some observers in both New 
Delhi and Washington see China working with Pakistan to constrain India’s influence, and China 
 
44 See, for example, David Albright, “Securing Pakistan’s Nuclear Weapons Complex,” Paper commissioned and 
sponsored by the Stanley Foundation for the 42nd Strategy for Peace Conference, Strategies for Regional Security 
(South Asia Working Group), October 25-27, 2001. In October 2022, President Biden remarked that Pakistan is 
“maybe one of the most dangerous nations in the world.... Nuclear weapons without any cohesion.” Four days later, a 
State Department spokesman stated that “the United States is confident of Pakistan’s commitment and its ability to 
secure its nuclear assets” (see President Biden’s October 13, 2022, remarks at https://tinyurl.com/kwtdt8ud, and the 
State Department’s October 17, 2022, transcript at https://tinyurl.com/4akw5wtu). 
45 Issues include “unlawful or arbitrary killings by the government or its agents, including extrajudicial killings; forced 
disappearance; torture; arbitrary detention; arbitrary or unlawful government interference with privacy” and severe or 
serious restrictions on free expression, the press, and the internet, among many others (see https://tinyurl.com/
2p8snxyr). See also CRS In Focus IF12198, 
India: Human Rights Assessments, by K. Alan Kronstadt.  
46 The Reporters Without Borders 
2023 World Press Freedom Index ranks Pakistan 150th of 157 countries. The World 
Economic Forum 
Global Gender Gap Report 2022 ranks Pakistan 145th of 146 countries in Economic Participation and 
Opportunity, and 143rd in Health and Survival (see the respective reports at https://rsf.org/en/index and 
https://tinyurl.com/5xfzm6ru).
 
47 See the May 15, 2023, release at https://tinyurl.com/4h93r8zz. 
48 See the May 1, 2023, release at https://tinyurl.com/3vd3htbu. 
49 See the December 26, 2019, Federal Register entry at https://go.usa.gov/xdGeV. 
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has provided diplomatic support for Pakistan’s Kashmir and foreign policies. Beijing is Pakistan’s 
primary international benefactor and arms supplier, and Chinese investments, companies, and 
workers are increasingly present in Pakistan. Military-to-military ties are extensive. Some 
analysts contend that Pakistan’s current economic crisis and political instability are serving to 
increase China’s influence there.50 
China has built a major new port at Gwadar, Pakistan, and is working to connect that to the 
western Chinese province of Xinjiang. These and other infrastructure and energy initiatives are 
part of the China-Pakistan Economic Corridor (CPEC), formally launched in 2014. This makes 
Pakistan the “flagship” of Beijing’s larger Belt and Road Initiative.51 Concerns that CPEC-related 
loans are partly responsible for Pakistan’s ongoing fiscal crisis have spurred debate, both within 
Pakistan and internationally, over the wisdom of current CPEC planning. Reports indicate that 
Pakistan owes China about $30 billion, nearly one-third of Pakistan’s total foreign debt.52 
Although Prime Minister Sharif in late 2022 indicated that CPEC is “a central pillar” of his 
government’s development agenda, analysts argue that CPEC “appears to have exacerbated 
Pakistan’s economic problems.”53  
Pakistan-India Relations and Kashmir 
Pakistan’s conflict and rivalry with neighboring India—essentially continuous over the more than 
seven decades since the 1947 Partition of British India—is unabated. The countries have fought 
four wars, most recently a 14-week-long clash in 1999, the first-ever between two nuclear-armed 
powers. Brief and limited incursions across the heavily-militarized border reportedly took place 
in 2016 and 2019. Pakistan’s claims to the disputed territory of the former princely state of 
Jammu and Kashmir are at the core of the bilateral discord (see
 Table 1). Islamabad has long 
sought to raise the issue of Kashmiri rights internationally, and it favors self-determination for the 
overwhelmingly Muslim residents of the Indian-held Kashmir Valley, the locus of a long-
simmering separatist conflict. India rejects any high-level bilateral peace negotiations absent 
decisive Pakistani action against anti-India militants inside Pakistan. Anti-India terrorist groups 
such as Lashkar-e-Taiba (responsible for the days-long 2008 terrorist assault on Mumbai) and 
Jaish-e-Mohammed (responsible for a deadly 2019 suicide bombing in Pulwama, Kashmir) 
apparently continue to operate, by some accounts supported by Pakistani state elements. U.S. 
policy seeks to prevent conflict between India and Pakistan from escalating.54 
Since mid-2022, there have been some limited signs of Pakistan-India rapprochement, in 
particular the continuing success of a cease-fire at the Line of Control in Kashmir since early 
2021. However, new disputes of river-sharing have emerged, and the two governments continue 
to trade bitter accusations. The U.S. intelligence community expresses concern about the potential 
 
50 
China’s Influence on Conflict Dynamics in South Asia, U.S. Institute for Peace Senior Study Group Report, 
December 2020; Uzair Younus, “With Pakistan’s Economy in Freefall, Chinese Economic and Military Influence Is 
Likely to Grow in the Country,” Atlantic Council, March 9, 2023; Samir Lalwani, “A Threshold Alliance: The China-
Pakistan Military Relationship,” U.S. Institute for Peace, March 22, 2023. 
51 See http://cpec.gov.pk. 
52 “U.S. Concerned About Debt Pakistan Owes China, Official Says,” Reuters, February 16, 2023; “China’s Funding to 
Pakistan Stands at 30% of Foreign Debt,” Bloomberg, September 2, 2022. 
53 Shehbaz Sharif, “Pakistan-China Friendship: A Sacred Tale of Abiding Trust and Love” (op-ed), 
Global Times (Beijing), October 30, 2022; Andrea Kendall-Taylor, et. al., “Competitive Connectivity: Crafting Transatlantic 
Responses to China’s Belt and Road Initiative,” Center for a New American Security, September 13, 2022. 
54 Joshua White, “Why America Can’t Escape Its Role in the Conflict Between India and Pakistan,” Brookings 
Institution, March 6, 2019, and the State Department’s December 19, 2022, briefing transcript at https://tinyurl.com/
443wypsr. 
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Pakistan and Pakistan-U.S. Relations 
 
for open conflict, even as its March 2023 annual report noted “current calm” in the India-Pakistan 
relationship.55 
Pakistan-Afghanistan Relations 
The August 2021 U.S. withdrawal from Afghanistan and the Afghan Taliban’s renewed rule over 
that country initially met with some apparent satisfaction in Islamabad—Pakistani leaders had 
long assessed the Afghan Taliban to be a relatively friendly and reliably anti-India element in 
Afghanistan.56 The ensuing 21 months have, however, seen increasing tensions arise between 
Islamabad and Kabul. Security forces at their shared border have engaged in intermittent and 
sometimes lethal clashes over Pakistan’s border fencing and immigration regulations, leading to 
mutual recriminations. More urgently for Pakistan, its homegrown Tehreek-e-Taliban Pakistan 
(TTP or “Pakistani Taliban”) has enjoyed a resurgence since 2021. This ethnic Pashtun, U.S.-
designated FTO arose in 2007 in Pakistan’s tribal agencies abutting Afghanistan, and its leaders 
sought refuge across the border in Afghanistan after suffering major losses during the Pakistan 
Army’s 2014 military operations against the group. The TTP is separate from, but ideologically 
aligned with, the Afghan Taliban, and it seeks to defeat the Pakistani government and institute 
Sharia law in the Khyber Pakhtunkhwa province (se
e Figure 1). The group has taken 
responsibility for numerous gun and bomb attacks on civilians and security forces in Pakistan 
over the past year, including a January 2023 mosque bombing in Peshawar that killed at least 101 
police officers.57 
Pakistan and the Russia-Ukraine Conflict 
The Islamabad government has maintained official neutrality in Russia’s war on Ukraine and has 
abstained on all relevant United Nations Security Council votes. Then-Prime Minister Khan was 
visiting Moscow on February 24, 2022—the day of Russia’s renewed invasion—and later called 
the timing “embarrassing,” saying the trip had been planned months in advance.58 The war has 
caused supply shocks leading to the rapid rise of fuel and food costs.59 Pakistan’s importation of 
Russian wheat has soared—it reportedly now is Russia’s fifth-largest wheat importer—and 
Islamabad recently began purchasing discounted Russian oil.60 At the same time, Pakistan 
reportedly has quietly been providing ammunition supplies, including 
Grad rockets, to Ukraine; 
the Islamabad government publicly denies such reports.61  
 
55 Derek Grossman, “India-Pakistan Ties Are Warming—But Don't Get Excited Just Yet,” RAND, September 29, 
2022; Rahul Mahadeo Lad and Ravindra Jaybhaye, “Troubled Waters: India, Pakistan, and the Indus Water Treaty 2.0” 
Diplomat, April 11, 2023; “India and Pakistan Trade Blame for Frosty Ties After SCO Meeting,” Reuters, May 5, 
2023. See the March 8, 2023, 
Annual Threat Assessment of the U.S. Intelligence Community at https://tinyurl.com/
4hjartj7. 
56 “Pakistan Rejoices at Taliban Victory as West Flounders,” 
Deutsche Welle (Berlin), August 18, 2021; “The Real 
Winner of the Afghan War? It’s Not Who You Think,” 
New York Times, August 26, 2021.  
57 Raza Khan Qazi, “As Pakistan’s Afghanistan Policy Fails, the Afghan Taliban Moves Against Islamabad,” Atlantic 
Council, September 6, 2022; Ahmed Waqas Waheed, “Pakistan’s Troubled Ties with the Taliban,” East Asia Forum, 
November 22, 2022; “Islamist Militants Have Pakistan’s Police in Their Crosshairs,” Reuters, February 27, 2023. 
58 Quoted in “Imran Khan Signals Desire to Build Bridges with Washington,” 
Financial Times (London), November 
12, 2022. 
59 “Pakistan Finance Minister Pushed Painful Fixes to Win Back IMF Lifeline,” 
Wall Street Journal, July 15, 2022. 
60 “Pakistan’s Wheat Imports from Russia Surge Eightfold on Supply Disruption from Ukraine,” 
S&P Global, March 
15, 2023; “Pakistan Makes Its First Purchase of Discounted Russian Oil,” Reuters, April 20, 2023. 
61 “Ukraine War: Bakhmut Defenders Worry About Losing Support,” BBC News (London), April 27, 2023; “Pakistan 
Denies Supplying Ammunition to Ukraine,” 
Dawn (Karachi), February 17, 2023. 
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Pakistan and Pakistan-U.S. Relations 
 
Issues Facing Congress 
Congress, in its legislative and oversight roles, could consider taking actions—including issuing 
its own assessments—on issues related to Pakistan and Pakistan-U.S relations. For example, 
Congress could consider the following: 
•  Whether or not the United States should engage in a substantive “reset” in its 
bilateral ties with Pakistan, especially in the wake of the U.S. military and 
diplomatic withdrawal from Afghanistan in 2021. This could include seeking to 
determine the best avenues to pursue in such an effort and metrics to assess its 
effectiveness. 
•  Pakistan is a country of more than 200 million people with nuclear weapons, 
numerous Islamist terrorist groups, and increasingly close ties to China. The 
Biden Administration’s February 2022 
Indo-Pacific Strategy, and its October 
2022 
National Security Strategy and 
National Defense Strategy make no mention 
of Pakistan. Congress could consider whether or not Pakistan should be explicitly 
incorporated into the U.S. Indo-Pacific strategy and, if so, in what way. Congress 
also could consider whether or not to develop and issue its own assessment of 
what role Pakistan should play in future U.S. regional and global strategy. 
•  Whether or not the United States should resume significant security assistance to 
Pakistan, and whether or not the United States should continue to offer 
sustainment services for Pakistan’s existing U.S.-supplied defense equipment. 
Congress could also consider conducting its own assessment of whether or not 
engaging in intelligence cooperation with Pakistan serves U.S. interests, and, if 
so, how effectively. 
•  Whether or not past U.S. aid to Pakistan has met its stated goals, and, if so, how 
effectively. Congress could consider developing and issuing its own assessment 
of how effectiveness may be improved. 
•  Whether or not assisting efforts to strengthen Pakistan’s democratic institutions 
and rule of law serves U.S. interests, and, if so, what actions, if any, might 
increase the effectiveness of such efforts. 
•  Whether or not to assist in efforts to ameliorate Pakistan’s economic crisis. For 
example, Congress could consider whether or not a phased reduction of tariffs on 
Pakistani textile imports to the United States would be an effective means to help 
develop Pakistan’s economy, as some analysts argue. Congress also could 
consider whether or not to renew the Generalized System of Preferences program 
and to Pakistani products eligible for duty-free import under that program again.  
•  Whether, and to what extent, the United States should assist Pakistan in its efforts 
to adapt to climate change and mitigate is effects. Congress also could consider it 
is in the U.S. interest to support “loss and damage” funds to compensate Pakistan 
for past damages attributed to climate change. 
•  Whether Pakistan’s governmental and civil society institutions are making 
effective efforts to combat the spread of religious extremism and militancy there, 
and consider whether or not to pursue congressional actions aimed at bolstering 
such efforts. 
•  The extent to which the TTP or “Pakistani Taliban” represent a substantive threat 
to Pakistan’s stability. Congress also could consider the extent to which anti-India 
terrorist groups in Pakistan pose a threat to U.S. regional interests. 
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Pakistan and Pakistan-U.S. Relations 
 
•  Assessing how secure Pakistan’s nuclear weapons arsenal and technologies are, 
and whether the United States can take steps to help in strengthening their 
security. 
•  Assessing what actions the Pakistani government is taking to protect the human 
rights of its citizens, perhaps in particular its religious minorities. Congress can 
consider what role or actions, if any, might be effective in strengthening 
freedoms of religion, expression, and the press there. 
•  Assessing the extent to which China’s increasing presence and influence in 
Pakistan might affect U.S. national and regional interests, as well as India’s 
interests. 
•  Assessing what the trends in Pakistan-India relations are, and what the prospects 
are for peaceful resolution of the Kashmir dispute. Congress also could consider 
whether or not U.S. government actions could be helpful in ameliorating 
Pakistan-India tensions and reducing the possibility and scope of future conflict, 
and, of so, which types of actions. 
•  Assessing the nature of Pakistan’s relationship with the Afghan Taliban now that 
the latter govern the country, and how that relationship affects U.S. regional 
interests and stability. 
•  Assessing the nature of Pakistan’s relations with Russia and Ukraine, and how 
this dynamic fits into the pursuit of U.S. goals in both Eastern Europe and South 
Asia. 
Table 1. Direct Overt U.S. Aid Appropriations for and  
Military Reimbursements to Pakistan, FY2002-FY2024 
(rounded to the nearest millions of dollars) 
Note: Final obligation and disbursement totals may be lower than program account appropriations 
FY2002-
FY 
FY 
FY 
FY 
FY 
Program or 
FY 
FY 
Program or Account  FY2017  2018  2019  2020  2021  2022  Account Total  2023 (req.) 2024 (req.) 
CN 
341 
— 
— 
— 
— 
— 
341 
a 
a 
FMF 
4,073 
— 
— 
— 
— 
— 
4,073 
— 
— 
IMET 
52 
— 
— 
— 
4 
3 
59 
4 
4 
INCLE 
949 
21 
40 
21 
25 
25 
1,081 
17 
17 
NADR 
182 
2 
2 
1 
1 
— 
188 
1 
1 
PCF/PCCF 
2,352 
— 
— 
— 
— 
— 
2,352 
— 
— 
Total Security-Related 
7,939b 
23 
42 
22 
30 
28 
8,406b 
22 
22 
Climate 
— 
— 
— 
— 
— 
— 
— 
9 
37 
CSH/GHCS/GHP 
295 
— 
— 
3 
7 
31 
336 
30 
32 
ESF/ESDF 
8,69
6c 
48 
62 
53d 
45 
50e 
8,954 
54 
82 
Food Ai
df 
643 
— 
— 
— 
— 
— 
643 
— 
— 
IDA 
1,065 
36 
— 
6 
3 
47 
1,157 
a 
a 
MRA 
371 
4 
28 
32 
2 
62 
499 
a 
a 
Total Economic-
Related 
11,356g 
88 
90 
94 
57 
190 
11,875g 
93 
151 
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Pakistan and Pakistan-U.S. Relations 
 
FY2002-
FY 
FY 
FY 
FY 
FY 
Program or 
FY 
FY 
Program or Account  FY2017  2018  2019  2020  2021  2022  Account Total  2023 (req.) 2024 (req.) 
CSF Reimbursementsg  14,573h 
h 
h 
— 
— 
— 
14,573 
— 
— 
Grand Total 
34,190 
111 
132 
116 
87 
218 
34,854 
115 
173 
Source: U.S. Departments of State, Defense, and Agriculture; U.S. Agency for International Development. 
Notes:  Abbreviations: 
CN: 
Counternarcotics Funds (Pentagon budget) 
CSF: 
Coalition Support Funds (Pentagon budget) 
GHP: 
Child Survival and Health; Global Health and Child Survival (GHCS) from FY2010; Global Health 
Programs (GHP) from FY2013 
ESF:  
Economic Support Funds; Economic Support and Development Funds (ESDF) from FY2018 
FMF: 
Foreign Military Financing 
IDA: 
International Disaster Assistance (Pakistani earthquake, flood, and internally displaced persons relief) 
IMET: 
International Military Education and Training 
INCLE: 
International Narcotics Control and Law Enforcement (includes border security) 
MRA: 
Migration and Refugee Assistance (also includes Emergency Refugee and Migration Assistance or 
ERMA; shows obligations) 
NADR: 
Nonproliferation, Anti-Terrorism, Demining, and Related (the great majority allocated for Pakistan is 
anti-terrorism assistance) 
PCF/PCCF: Pakistan Counterinsurgency Fund/Counterinsurgency Capability Fund (PCF overseen by the 
Pentagon, PCCF overseen by State) 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
a.  This funding is “requirements-based”; there are no pre-allocation data. 
b.  Includes $312 mil ion “global train and equip” funds from FY2006-FY2009 authorized by Section 1206 of the 
National Defense Authorization Act (NDAA) for FY2006, within which $100 mil ion in FY2008 and FY2009 
funds was for Pakistan’s paramilitary Frontier Corps. 
c.  Congress authorized Pakistan to use the FY2003 and FY2004 ESF allocations to cancel a total of $1.5 bil ion 
in debt to the U.S. government. Also includes $17 mil ion in Human Rights and Democracy Funds from 
FY2002-FY2007. 
d.  Includes $7 mil ion in FY2020 COVID supplemental funds. 
e.  Includes $10 mil ion in supplemental FY2022 ESF under the Additional Ukraine Supplemental Appropriations 
Act, 2022 (P.L. 117-128). 
f. 
P.L.480 Title I (loans), P.L.480 Title II (grants), and Section 416(b) of the Agricultural Act of 1949, as 
amended (surplus agricultural commodity donations). Food aid totals do not include freight costs. 
g.  Includes $286 mil ion in Development Assistance appropriated from FY2002-FY2008. 
h.  CSF was Defense Department funding to reimburse foreign forces for logistical and operational support of 
U.S-led military operations; it is technically not foreign assistance. Beginning in FY2015, successive NDAAs 
subjected one-third to one-half of annual CSF to Pakistan to Haqqani Network-related certification 
requirements that could not be waived by the Administration. The Administration did not issue 
certifications for FY2015-FY2018. The NDAA for FY2019 revamped the CSF program, authorizing $350 
mil ion to support security enhancement activities along Pakistan’s western border, subject to certification 
requirements that have not been met to date. The NDAA for FY2020 disallowed the use of FY2020 funds 
to reimburse Pakistan. 
 
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 Pakistan and Pakistan-U.S. Relations 
 
Figure 1. Map of Pakistan 
 
Source:
Pakistan and Pakistan-U.S. Relations 
 
Figure 1. Map of Pakistan 
 
Source: Adapted by CRS. 
 
 
Author Information 
 K. Alan Kronstadt 
   
Specialist in South Asian Affairs     
Congressional Research Service  
 
13 
Pakistan and Pakistan-U.S. Relations 
 
 
 
Disclaimer 
This document was prepared by the Congressional Research Service (CRS). CRS serves as nonpartisan 
shared staff to congressional committees and Members of Congress. It operates solely at the behest of and 
under the direction of Congress. Information in a CRS Report should not be relied upon for purposes other 
than public understanding of information that has been provided by CRS to Members of Congress in 
connection with CRS’s institutional role. CRS Reports, as a work of the United States Government, are not 
subject to copyright protection in the United States. Any CRS Report may be reproduced and distributed in 
its entirety without permission from CRS. However, as a CRS Report may include copyrighted images or 
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Congressional Research Service  
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