Since Pakistan joined the "war on terror", it has received billions of dollars from the United States. When Osama Bin Laden was found here, there were those in Washington who said aid to this country had to stop.
But it is not just Americans questioning the current levels of financial assistance here, many Pakistanis are also debating the wisdom of accepting such large sums of US handouts.
Muzaffar Khakwani, who grows mangoes in the southern part of Punjab province, is a direct recipient of American aid.
In the scorching heat he shows off his trees, heavily laden with green fruit, still a few weeks away from being harvested.
"The US assistance in this area has gone primarily into education of mango farmers like me," Mr Khakwani says. "How to grow better mangoes in terms of quality and yield, how to market our mangoes better, and also into trying to create the conditions to increase exports of our mangoes."
He says the Americans have contributed to the building of a processing facility on his farm.
"I guess the idea is that because southern Punjab has had problems with militancy, if they invest here it will become prosperous and the money will trickle down to the poor so they won't become militants," says Mr Khakwani.
Over recent years much of the American money to Pakistan has gone to the army, but about $1.5bn a year has been assigned to civil projects too.
Not far away from Mr Khakwani's farm, is the site of another civil assistance project being funded by the US.
The Americans have invested in the thermal power station, increasing its capacity so it serves thousands more homes.
But in a market in the nearby city of Muzaffargarh some of the intended beneficiaries of the aid told us they did not want it.
"Our country's got so many problems," one man told me. "America is the cause. If they damage our country, or kill our people, we don't accept their money." All around nodded in agreement.
If the aid is a tool to "win hearts and minds," it is not working here.
But the head of the USAID (US Agency for International Development) mission to Pakistan, Andrew Sisson, says the highs and lows of the US-Pakistan relationship should not detract from the long term goals.
"Well, of course, we would like a more favourable Pakistani perception of the US government and our assistance but that's not the main reason we're here," says Mr Sisson.
"We're here to promote development, stability, to help this place become less susceptible to extremist tendencies."
Mr Sisson said America had committed itself to much more investment in sectors that would improve the lives of Pakistanis.
But there is another face of American involvement here, its military operations. It includes the US drone missile strikes against suspected militants in Pakistan's tribal areas close to the Afghanistan border.
The opposition politician, Imran Khan, says the drone attacks and the Pakistani army offensives against militants are precisely the things that are fuelling extremism here.
"It's because we're perceived as an American hired gun, we're being paid," Mr Khan says.
"I have never seen such anti-Americanism in Pakistan as now, why? If they were our ally we should be friends. It's because the majority of the people feel that we're being used in someone else's war and we are being destroyed by it."
Imran Khan is leading a vociferous campaign advocating an immediate end to both military co-operation with the US, and to Pakistan's acceptance of American aid.
"Things cannot get any worse. Every day Pakistanis are dying," he says. "So we might as well try another policy where we, as a sovereign country, try and reform rather than rely on aid. Better to start the process now and stop this bloodshed going on in this country."
Though Mr Khan passionately insists it is the right strategy, the task of going it alone in dealing with the estimated tens of thousands of militants here is a daunting one for Pakistan.
The kind of reforms needed to revive an economy that has become dependent on aid are also huge.
The head of USAID here, Andrew Sisson, says it would affect many people if the aid programme stopped.
"Millions of Pakistanis, children in particular, but also adults, will lose the opportunity for economic improvement in their lives, as well as better health and education or better services like clean water."
Back at his mango farm, in southern Punjab province, Muzaffar Khakwani told us it would affect him personally if the aid was cut.
"The research stations and the experts will not be available and they have been of great use, and it would have an effect on all the work to build the capacity of the farm."
But even he has reservations about what accepting American aid may be doing to the country.
"It may be holding us back," he says. "Should the aid stopped we would have to find ways to survive, we did in the past. It might be good for us, but only if the Pakistani leaders make the right decisions to get us back on our feet. But that's a big 'if'."