Traditionally one of the largest recipients of U.S. foreign assistance, Egypt has annually received between $1 billlion and 2 billion in military and economic assistance since the Camp David peace agreement. Meanwhile, presidents from Carter to Obama have ever so gently prodded Egypt to make political reforms, mindful of Cairo's pivotal role in the region in supporting the Israeli-Palestinian peace initiatives, as well as opposing al-Qaida and Islamist extremists.

Egypt may have continued to stumble along, but its future collided with the present. Here's what happened.

First, Mubarak, who perpetually dyes his hair black, has nonetheless grown older and visibly infirm. The president fainted while making a televised speech seven years ago -- the broadcast was immediately cut until he was revived. Last year, Mubarak had gall bladder surgery in Germany and was forced to spend two months there in the hospital.

What worried Egyptians and U.S. policymakers was Mubarak's refusal to name a vice president, someone who could step in. But a possible successor emerged -- Gamal Mubarak, the younger of the president's two sons. Within the last 10 years, the 47-year-old former banker made a meteoric rise from relative obscurity to the deputy secretary general of the ruling party.

The younger Mubarak participated in cabinet meetings, reportedly even selecting some of the ministers. Recently he began to make public addresses in his father's place. This raised fears of a father-to-son succession in the Arab world's first republic.

Presidential elections are scheduled for September, but the elder Mubarak has not officially announced that he will seek a fifth term. This fueled speculation that he would step aside for his son to emerge as the presidential candidate of the ruling party and his successor. Posters promoting the younger Mubarak started appearing on the streets of Cairo last fall, leading to a round of protests.

Egypt's continuing turmoil has ended such speculation, when late last week Mubarak named his shadowy intelligence chief, Omar Suleiman, 74, as his vice president.

The sudden selection of Suleiman, the head of the dreaded Mukhabarat, or secret police, has not gone over well with the opposition. His rise to prominence began in June 1995, when he ordered Mubarak's bulletproof limousine transported to Ethiopia. Suleiman was sitting next to Mubarak when assassins ambushed the vehicle driving into the Ethiopian capital. The bullets bounced off the limo, and Suleiman became perhaps Mubarak's most trusted confidante. He personally handles Egypt's sensitive security negotiations with Israel regarding the Palestinians, specifically the besieged Gaza Strip.

What does this mean for Egypt and the United States?

If Mubarak resigns, Suleiman would succeed under the constitution. But because of his age and poor health (he has survived four heart attacks), he may, at best, play a role as the army's caretaker, while a broad-based provisional government prepares Egypt for truly democratic presidential elections in the fall.

A democratic Egypt's ties with Washington could change considerably in the future. The Egyptian public has not supported the Mubarak government's role of cooperating with Israel's economic siege and blockade of Gaza. Nor is there any public enthusiasm for thawing the country's "cold peace" with the Jewish state. A new Egyptian government would probably not abrogate the Camp David accords, or support a return to war, but it could mean severely downgrading existing ties with Israel. This could lead to new friction with both Tel Aviv and Washington.

While a new Egyptian government would probably continue to support Washington's war against al-Qaida, a government truly reflecting public sentiment would likely be quite critical of the American military presence in Iraq and Afghanistan.

So while there is widespread public admiration for America and Americans, this has never been the case for American foreign policy. Once Mubarak leaves the scene, an Egyptian government reflecting popular sentiment would not automatically make Cairo an enemy of Washington. But the days when Egypt could be regarded as a close friend and reliable ally are probably over.

Sunni M. Khalid is the managing news editor at WYPR-FM and has reported extensively throughout Africa and the Middle East. He reported from Cairo for three years.

Like The Root on Facebook. Follow us on Twitter.