Pope Francis celebrates 12 years as leader of the Catholic Church on Thursday, marking the anniversary as concerns about his health continue to grow. The 88-year-old pope recently fought off a serious case of pneumonia, resulting in a prolonged hospitalization that has raised questions about his future as leader.

The Vatican confirmed Wednesday that Francis continues in stable condition, with hopes for recovery. But his longest hospital stay as pope has generated serious questions about whether he can continue to handle the demands of leading almost 1.4 billion Catholics globally.

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Health Struggles and Possible Slowdown

During his stint, Pope Francis has been characterized by his energetic leadership, never showing signs of slowing down despite his age and health issues. He has been globe-trotting for years, even undertaking a 12-day Asia-Pacific tour in September 2023.

But doctors recommend that, based on his age and history of respiratory problems, full recovery could be weeks or months away. Father Michel Kubler, a Vatican specialist, added the element of uncertainty in the remainder of Francis’ papacy.

“The remainder of his pontificate is a question mark for the time being, even for Francis himself,” Kubler said in an interview with AFP. “He doesn’t know what his life will be like when he goes back to the Vatican and so no doubt keeps the option of resigning open if he can no longer manage.”

While Pope Francis has left open the possibility of resignation in the past, following the precedent set by Pope Benedict XVI in 2013, he has more recently dismissed the idea, insisting that the role of pope is a lifelong commitment.

Since being hospitalized, he has left tasks to upper-level cardinals but has been working sporadically, issuing decrees and seeing close associates. Still, he has been absent for an entire month of important preparations for the 2025 Jubilee, which is projected to bring 30 million pilgrims to Rome and the Vatican. With Easter now only five weeks away, worries persist over whether he will be able to preside over its full slate of events.

Incomplete Reforms and A Split Church

Pope Francis’ papacy has been marked by far-reaching reforms to remake the Church as a modern organization. He has worked to more inclusively enfold the Catholic Church, preaching for the protection of the downtrodden’s rights and instilling financial disclosure in the Vatican.

His reforms have covered the remaking of Vatican finances, widening opportunities for women, and being more open towards divorced people and LGBTQ+ members. Not every change has found acceptance, with traditionalists fiercely resisting many of his efforts.

There was a huge controversy in 2023 when the Vatican explained its position on non-liturgical blessings for gay couples. The action provoked criticism, especially in Africa, of the Church’s continued resistance to Francis’ liberal policies.

One of the key Vatican debates on the future of the Church, the Synod, is still incomplete, so it is uncertain if his vision will be completed.

“Whether you like him or not, he’s moved the needle, but much remains outstanding,” a Vatican source said.

A Turning Point for the Papacy

As Pope Francis celebrates this milestone, his papacy’s future is not certain. Even though he has been displaying toughness, his current health issues hint at significant transformations in the making. Whether he decides to retire, hand over more duties, or even resign is yet to be determined.

With the 2025 Jubilee and Easter festivities approaching, everyone is watching the Vatican to observe how Pope Francis handles the challenges facing him. His legacy as a reformist pope is already set, but his next moves may be what determines how much of his vision becomes a permanent reality.