The European Union, crucible of the debt crisis in 2012, is in the middle of an austerity drive that has left 26 million people out of work, almost 19 million in the eurozone. In Spain, every other worker under 25 is out of a job.
While recession has forced governments and lenders to relax debt targets and ease deadlines, there's no hint of a change in the direction of travel.
"Our patient may be out of intensive care, but it will still take some time before she can be given a clean bill of health," said Olli Rehn, the EU's top economic official, in a recent speech. "That's why any lapse into complacency would be unforgiveable."
Initiatives such as the launch of a bailout fund, the first tentative steps toward a banking union, and the ECB's pledge to buy short-term debt from struggling eurozone members have gone a long way to reassure investors that the euro is not about to disintegrate.
But the pace of reform this year could slacken as the backlash against austerity grows, Germany and Italy go to the polls, and market pressure for change subsides.
"In 2013, the risks shift from threat of financial crisis to a loss of momentum in creating the institutional and policy frameworks for a redesigned union," political risk consultancy Eurasia Group wrote in its annual outlook.
Governments may also find reform of labor and product markets to restore European competitiveness hard going.
"That's where action is needed, and will continue to be needed in the future," ECB President Draghi said last week.
Credit rating agency Standard & Poor's says the need for further reform will challenge Europe's leaders, and strain the political consensus if the pain isn't more evenly shared and vulnerable citizens aren't better protected.
"Safeguards to the social contract may be necessary to assist in the cohesion of those member states suffering from high unemployment, excessive private leverage, and stagnating or falling living standards," said S&P analyst Moritz Kraemer.