President Obama has asked Uzbekistan to expand its role in resupplying troops in Afghanistan as Washington tries to reduce its dependence on Pakistan.
The past fortnight has seen relations between Islamabad and Washington sink to new lows over allegations that Pakistan's Inter-Services Intelligence agency was working with the Haqqani network to direct attacks on American targets in Afghanistan.
The crisis, the latest in a turbulent year, has seen both countries scrambling to build up alternative regional alliances.
However, more than a third of supplies to Nato forces in Afghanistan pass through Pakistan, giving Islamabad a strong bargaining position.
> Central Asia Map
A White House official said President Obama had discussed sending more supplies through the former Soviet republic of Uzbekistan during a phone call with the country's president, Islam Karimov.
At the same time, Hillary Clinton met her Uzbek counterpart on Thursday, and Congress is considering legislative changes that would allow more military aid to the Central Asian despite its poor human rights record.
"We value our relationship with Uzbekistan. They have been very helpful to us with respect to the Northern Distribution Network," said Mrs Clinton.
That route winds its way through Eastern Europe, Russia and Central Asia to Afghanistan and has already become more important in the past year as the US began switching supplies from Pakistan's roads.
But closer ties will anger human rights organisations which have protested proposed plans to send military aid to Uzbekistan for the first time since 2004, when funds were choked off as penalty for the country's poor human rights record.
Twenty groups, including Amnesty International, Human Rights Watch and International Crisis Group, signed a letter of protest sent to Mrs Clinton before her meeting with Mr Ganiev.
"We call on you to stand behind your strong past statements regarding human rights abuses in Uzbekistan," the letter said.
"We strongly urge you to oppose passage of the law and not to invoke this waiver."
At the same time, Pakistan has been looking to China as a foil for its dependence on the US with a series of high-level meetings during the past week.
However, yesterday it emerged that China Kingho Group had pulled out of a $19bn deal in southern Pakistan because of security concerns, according to The Wall Street Journal – suggesting Islamabad may not be able to rely on its giant neighbour as an alternative to the US.