The US strategy to defeat Al-Qaeda and the Taliban tripled American troops fighting in Afghanistan and doubled missile strikes in Pakistan, but hangs in the balance after a year of record violence.
Since taking office, President Barack Obama has ordered more than 50,000 extra troops into battle to reverse Taliban momentum and build up Afghan government forces so that combat troops could start leaving in 2011.
There are more than 140,000 US-led NATO troops on the ground -- two-thirds of them American -- and 2010 has proved to be the deadliest year on record with the deaths of at least 683 foreign soldiers.
Eclipsing the toll of 521 soldiers last year, on average two NATO soldiers died each day this year. The United Nations declared the first six months of 2010 as 30 percent deadlier for Afghan civilians than last six months of 2009.
The Taliban have made increasing inroads into the north and west. Killings and kidnappings of Western aid workers have put much of rural Afghanistan, which suffers from huge poverty and social problems, off-limits.
Flagship offensives in the narcotics hub of Marjah in Helmand province and Kandahar, the Taliban's spiritual home and the largest city in the south, have, at best, received mixed reports of success.
In a damning assessment of America's key ally, US memos leaked by Internet whistleblower WikiLeaks said no amount of US aid money would ever convince Pakistan to abandon support of the Afghan Taliban.
Obama's controversial announcement in late 2009 that US troops would start leaving Afghanistan in July 2011 is now mentioned less and less often.
In July, the international community endorsed pledges from Afghan President Hamid Karzai to assume total responsibility for security by the end of 2014.
But just four months later at a NATO summit in Lisbon, Obama acknowledged US combat troops might remain into 2015.
Obama then flew into Afghanistan on December 3 to tell cheering American troops "you're achieving your objectives, you will succeed in your mission".
But the fact that he stayed only three hours under the cover of darkness and never left Bagram Air Field spoke volumes about the real state of security.
The White House attributed the decision to bad weather and the Afghans insisted there were no hard feelings, but the cancellation of talks with Karzai in Kabul did nothing to dispel fears of a fraying political alliance.
US General David Petraeus, NATO commander in Afghanistan, has expressed doubts about victory by 2014, admitting that the Taliban continually regroup.
In November, a Pentagon report said progress was "uneven" with only modest gains against the Taliban.
Despite escalating drone strikes, Washington still considers Pakistan's tribal belt on the Afghan border the most dangerous place on Earth, the global headquarters of Al-Qaeda and a rear base for Afghan Taliban.
According to an AFP tally, at least 92 drone strikes have killed more than 600 people from January 1 to mid-December, compared to 45 killing 420 people in 2009. But there is seemingly no shortage of Islamist extremists willing to attack the West.
A bomb plot in New York on May 1 was hatched by a financial analyst trained in Pakistan's North Waziristan. Alleged plots to attack Europe in October were also rooted in Pakistan's tribal belt, Western intelligence agents said.
Politically, the Afghan and Pakistani governments seem weaker than ever, tainted by corruption despite near unconditional financial support running into billions of dollars from Washington.
US ambassador Karl Eikenberry wrote in one cable that Karzai was "paranoid and weak" and "unfamiliar with the basics of nation building", raising the question as to whether Washington can succeed without a solid partner in Kabul.
Parliamentary polls that the West hoped would clean up massive fraud that marred Karzai's re-election in 2009 threw out a quarter of votes for graft.
In Pakistan, the popularity of President Asif Ali Zardari sank to new lows as catastrophic flooding left a fifth of the country under water, affected 21 million people and saw the already faltering economy take a further nosedive.
Zardari's weak government has no hold over the military, which has withstood US pressure to launch an offensive against Afghan Taliban and the Haqqani network in North Waziristan.
Pakistan, the only nuclear power in the Muslim world, has lost nearly 4,000 people over the last year in a series of suicide and bomb attacks blamed on Taliban allied to Al-Qaeda, including more than 1,000 people in 2010.