President Donald Trump rang in 2018 with a Twitter outburst targeting Pakistan, saying Monday the U.S. has only gotten "lies and deceit" for the billions it's given in aid to the southwest Asian nation.

Hours later a White House National Security spokesperson said the U.S. would be withholding $255 million in aid to Pakistan as the administration reviews Pakistan's "level of cooperation" in fighting terrorism.

Pakistani officials reportedly denied Trump's accusations and summoned the U.S. Ambassador to Pakistan to the foreign office to lodge a formal protest, according to local reports.

The outburst comes nearly five months after Trump announced he was taking a tougher stance towards Pakistan, and promised that the sheltering of terrorists "will change immediately." By December, CIA Director Mike Pompeo suggested publicly that the new strategy wasn't working.

Related: Trump's 'New Strategy' for Pakistan and Terrorism Not Working Yet

The ratcheting up of tensions between the U.S. and Pakistan is certain to have larger geopolitical consequences in the region, especially for the counter-terrorism fight in Afghanistan, but it could also have a profound effect on one man: Dr. Shakil Afridi, the physician who helped the CIA in its search for al Qaeda leader Osama bin Laden.

In the aftermath of bin Laden's death at the hands of U.S. Navy SEALs in Abbottabad, Pakistan in May 2011, Afridi was identified as having set up a vaccination program on behalf of the CIA designed to gain access to DNA from bin Laden or his family members. The operation reportedly failed, and Afridi later said he didn't know who the target was, but Pakistan convicted him of treason anyway for his role in what Pakistan saw as an embarrassing violation of its sovereignty.

U.S. officials and lawmakers have repeatedly called on Pakistan to release the "hero" doctor, but Pakistan has not complied. As a candidate for president, Trump told Fox News in April 2016 that if elected, he would get Afridi out of prison "in two minutes."

"I would tell them let them out and I'm sure they would let them out. Because we give a lot of aid to Pakistan. We give a lot of money to Pakistan," he said then. "And frankly, they will do -- they don't have any respect for our president. But when you say they take advantage or they are no friend."

After Trump's electoral victory, an attorney for Afridi said things were looking up, but the lack of movement since indicates that appeared to be false hope.

"We believe Dr. Afridi has been unjustly imprisoned and have clearly communicated our position to Pakistan on Dr. Afridi's case, both in public and in private,” the State Department told Voice of America in April. “We continue to raise this issue at the highest levels during discussions with Pakistan's leadership. Pakistan has assured us that Dr. Afridi is being treated humanely and is in good health."

At the time of the VOA report, Afridi had marked six years in prison -- with 27 left to go.

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