"The popular perception that the public has seen little benefit from the billions of U.S. funding has encouraged a number of conspiracy theories about the ultimate and malignant objectives of the U.S. government as exercised through its assistance programs," Christine Fair, a Pakistan expert at Georgetown University, told Congress in 2009.
Andrew Wilder, a former head of Save The Children in Pakistan and director of Afghanistan and Pakistan programs at the U.S. Institute of Peace, a Washington think tank, adds: "The idea that by giving them money we can buy their hearts and minds is a rather simplistic analysis of what's driving anti-American sentiment in Pakistan."
Public sentiment has been hurt by the Central Intelligence Agency's ongoing campaign to use missiles fired from pilotless drones to kill al Qaeda and Taliban fighters in Pakistan's tribal regions. Civilians also have been killed in such attacks.
U.S. officials do not acknowledge the drone strikes and won't comment on how they might affect public opinion. "It is in both countries' and the region's interest to have security and stability on both sides of the Afghan/Pak border—an elusive but attainable goal," said Alberto Rodriguez, a U.S. embassy spokesman in Islamabad, in an email.
Mr. Khan, the Bajaur refugee who is critical of the drone attacks, recently received USAID-branded food from a United Nation's distribution post in Charsadda, a town northeast of Peshawar. Even though the Taliban has been targeting food-distribution centers, he laid blame for the escalating violence on the U.S. On Christmas Day, the Taliban claimed responsibility for an attack by a female suicide bomber who killed 46 in Bajaur.
Shaukat Khan, another refugee who has received food from USAID, faults the U.S. for his predicament. "In Bajaur, we had a lot of land planted with crops, but these were destroyed by America," he said recently, speaking in a squalid room near Charsadda, where he is living with his wife and five children, the youngest only days old. "It's because of America being in Afghanistan that Bajaur is not at peace."
A road project in South Waziristan, a tribal region that has been a base for Taliban militants and a focus of the CIA's drone campaign, shows how difficult it is to use aid to change public sentiment.
A year ago, the U.S. signed an agreement to pump $55 million through a local government body into roads, water and electricity in South Waziristan, where anti-Americanism is rampant. Six months ago, to improve access to markets, schools and health facilities, workers began transforming a winding, potholed mountain road between the towns of Tank and Makin into a wide, paved road. Because of militant attacks, the Pakistani army's public-works division is leading construction.
Habibullah Khan, a senior government official in the region, said the move to fund bigger infrastructure projects in South Waziristan has gained local support. But he said it's too dangerous for now to put any USAID logos on the road because of possible reprisals against workers. He said the government plans to do so once the road is finished.
Haji Mursalin, a tribal elder from the region, says locals support the road but don't like America any more as a result. "The construction of roads won't work because our whole social structure has been destroyed," Mr. Mursalin said. "Most of the common people are against drone strikes because most of the time there are civilian casualties and collateral damage."
Last summer's devastating floods in Pakistan, which killed almost 2,000 and affected 20 million others, gave the U.S. a chance to showcase its assistance. When Mr. Holbrooke visited the flood zone in September, he stressed that the U.S. was the biggest donor to flood relief. USAID paid for emergency food, shelter and seeds for the winter's wheat-planting season.
Haq Nawaz, a 38-year-old farmer from Nowshera Kalan, a village near Peshawar, lost his house and crops. He received seeds for wheat, peas and radishes from a local organization helping farmers on behalf of USAID. But his view of the U.S. hasn't changed.
"I like America's money, but I don't like their bullets," he said. "It is fair enough that they are fighting the Taliban, but they kill too many innocent civilians."
—Rehmat Mehsud contributed to this article.
Setbacks Plague U.S. Aid to Pakistan - WSJ.com