A stable, democratic, prosperous Pakistan actively working to counter Islamist militancy is considered vital to U.S. interests. Current top-tier U.S. concerns regarding Pakistan include regional and global terrorism; stability in neighboring Afghanistan; domestic political stability and democratization; nuclear weapons proliferation and security; human rights protection; and economic development. Pakistan remains a vital U.S. ally in U.S.-led anti-terrorism efforts. Yet the outcomes of U.S. policies toward Pakistan since 9/11, while not devoid of meaningful successes, have seen a failure to neutralize anti-Western militants and reduce religious extremism in that country, and a failure to contribute sufficiently to stabilizing Afghanistan. Domestic terrorist bombings and other militant attacks became a near-daily scourge in 2008 and continue at a high rate to date, with Islamist extremism spreading beyond western tribal areas and threatening major Pakistani cities. In the assessment of a former senior U.S. government official, "Pakistan is the most dangerous country in the world today. All of the nightmares of the twenty-first century come together in Pakistan: nuclear proliferation, drug smuggling, military dictatorship, and above all, international terrorism." When asked in early 2010 what worried him the most of all foreign policy issues, Vice President Joseph Biden answered "Pakistan," which he said has deployable nuclear weapons, "a real significant minority of radicalized population," and "is not a completely functional democracy." A long-time U.S.-based observer sees the fundamentals of the Pakistani state in 2011 "either failing or questionable," and proffers that, with all current U.S. policies proving ineffective, Pakistan is moving in a direction of "comprehensive failure," perhaps in as few as four years. The U.S. State Department issues stern warnings on the risks of travel to Pakistan, and many independent country indices rank the Pakistani state as a failed or failing one. The Pakistani state and people are paying a steep price for their participation in the fight against Islamist militancy and extremism. Foreign Minister Shah Mehmood Qureshi claims that, in the post-9/11 period, Pakistan has incurred some 31,000 casualties and has "arrested, apprehended, and eliminated 17,000 terrorists." Socioeconomic costs have been high, as well, and include massive human displacement; increased funding for security and law enforcement institutions, and reconstruction; sharply reduced investment and capital flight; and all manner of less tangible infrastructural and cultural costs. Pakistani government officials estimate financial losses of up to $40 billion since 2001. The severe psychological toll on the Pakistani people has led to an upsurge in reports of depression, anxiety, paranoia, and post-traumatic stress disorders. Pakistan's troubled economic conditions, fluid political setting, and perilous security circumstances present serious challenges to U.S. decision makers. On the economic front, the Islamabad government faces crises that erode their options and elicit significant public resentment. On the political front, a weak civilian leadership, ongoing power struggles between the executive and judiciary, and discord in federal-provincial relations all serve to hamper effective governance. On the security front, Pakistan is the setting for multiple armed Islamist insurgencies, some of which span the border with Afghanistan and contribute to the destabilization of that country. Al Qaeda forces and their allies remain active on Pakistani territory. The compounded difficulties faced by Pakistan and those countries seeking to work with it, along with the troubling anti-American sentiments held by much of the Pakistani public, thus present U.S. policy makers with a daunting task. Despite some positive signs, the progress of U.S.-Pakistan relations in the post-2001 era has produced few of the main outcomes sought in both capitals. Religious, ethnic, and political violence in Pakistan has only increased, as has an already intense anti-Americanism. While a reasonably free and fair election did seat a civilian government in 2008, that government remains weak and saddled with immense economic and other domestic problems. Meanwhile, the security institutions maintain a hold on the formulation of foreign and national security policies, and some elements appear to have lingering sympathies for the Afghan Taliban and other Islamist militant groups. From the U.S. perspective, Pakistan's status as a hotbed of religious extremism has only become more secure in recent years, Al Qaeda continues to operate in the tribal areas, and Afghanistan remains unstable more than nine years after the U.S.-led intervention there. More recently, there are disturbing signs that Pakistan serves as a site for the recruiting and training of American nationals intent on carrying out terrorist attacks on the U.S. homeland. In late 2010, an unnamed senior Pakistani military official, widely believed to be Pakistani Army Chief General Ashfaq Pervez Kayani himself, described Pakistan as having "transited from most sanctioned ally to most bullied ally." He located Pakistani resentment in the perception that the United States continues to pursue a "transactional relationship" with Pakistan, that it seeks "controlled chaos" inside Pakistan, and that its true strategy is to "denuclearize" Pakistan. Kayani has thus far resisted U.S. efforts at persuasion and has shown other flashes of defiance in recent months, including issuing a reportedly personal order to close the Torkham border crossing after two Pakistani solders were killed by a NATO helicopter in September. Notwithstanding Pakistan's ongoing and serious problems—including rampant domestic militancy, political and economic crises, and deep-seated resentments toward the United States and neighboring India—Obama Administration decision makers appear to see no viable alternative but to continue supporting the country and are ready to "double down" with additional military and economic support. This reportedly was the message Vice President Biden carried with him during a January 2011 visit to Islamabad. While there, the U.S. Vice President reiterated his and President Obama's view that Pakistan is "absolutely vital" to U.S. interests, and he took the opportunity to correct some key misconceptions held among Pakistanis, including that the United States represents a threat to their sovereignty ("I would respectfully suggest that it's the extremists who violate Pakistan's sovereignty and corrupt its good name"), that America disrespects or is an enemy of Islam, that U.S. policies favor India in ways that could lead to Pakistan's weakening, and that the U.S. will "abandon" Pakistan. A key aspect of the Obama Administration's approach to Pakistan has been development of a more coherent policy to include a tripling annual nonmilitary aid to improve the lives of the Pakistani people, with a particular focus on conflict-affected regions, and on focusing increased U.S. military aid to Islamabad on counterinsurgency goals while conditioning such aid on that government's progress in combating militancy. President Obama, Vice President Biden, and Secretary of State Hillary Clinton all supported the Enhanced Partnership With Pakistan Act of 2008 in the 110 th Congress (which was never passed), and they strongly encouraged the 111 th Congress to pass a newer version of that legislation. This Pakistan Enduring Assistance and Cooperation Enhancement Act of 2009 ( H.R. 1886 ) was passed by the full House in June 2009, then reconciled with the Senate bill passed that September. President Obama signed the resulting Enhanced Partnership with Pakistan Act (EPPA) of 2009 into P.L. 111-73 on October 15, 2009. The legislation is commonly referred to as the "Kerry-Lugar-Berman bill." Even as President-elect, Obama asserted that Afghanistan cannot be "solved" without "solving Pakistan" and working more effectively with that country, saying he believed Pakistan's democratically-elected government understands the threat and would participate in establishing "the kind of close, effective, working relationship that makes both countries safer." Pakistani President Asif Ali Zardari said his country looked forward to a "new beginning" in bilateral relations, but repeated his admonition that Pakistan "needs no lectures on our commitment [to fighting terrorism]. This is our war." His government repeatedly has asked the Obama Administration to strengthen Pakistan's democracy and economic development in the interest of fighting extremism. Despite Pakistani hopes that President Obama would more energetically engage diplomatic efforts to resolve the Kashmir problem, the Administration has offered no public expressions of support for such a shift. Secretary of State Clinton has recognized the dangers of rising tensions in Kashmir while also deferring calls for greater U.S. involvement there, saying during her confirmation hearing that the U.S. role will continue to be as it was under the previous Administration: settlement facilitation, but no mediation. In what many observers considered to be a bracing U.S. government wake-up call to Islamabad, Secretary Clinton told a House panel in April 2009 that "the Pakistani government is basically abdicating to the Taliban and to the extremists." Secretary of Defense Robert Gates followed with his own warning that U.S.-Pakistan relations could suffer if Islamabad did not "take appropriate actions" to deal with the militant threat. Days later, President Obama himself expressed "grave concern" about the situation in Pakistan, offering that the "very fragile" civilian government there did not appear to have the capacity to deliver basic services to the Pakistani people. He did, however, acknowledge that the Pakistani military was showing more seriousness in addressing the threat posed by militants. The Administration's tone shifted considerably after Pakistani forces launched major offensive operations against Taliban militants in the Swat Valley. Senior U.S. officials—including President Obama in his December 1, 2009, speech—laud Pakistan's military operations against indigenous Taliban militants. Yet these officials also want Islamabad to enlarge the scope of such operations to include action against a broader array of extremist threats, including those of the greatest concern to India and Western countries.