Reform movements showed no sign of flagging despite bloodshed on the streets and arrests last year, Amnesty International said on Monday in its report "Year of Rebellion: State of Human Rights in the Middle East and North Africa".
"With few exceptions, governments have failed to recognise that everything has changed," Philip Luther, Amnesty International's interim Middle East and North Africa director, said in a report.
"The protest movements across the region, led in many cases by young people and with women playing central roles, have proved astonishingly resilient in the face of sometimes staggering repression.
"They want concrete changes to the way they are governed and for those responsible for past crimes to be held to account.
"But persistent attempts by states to offer cosmetic changes, to push back against gains made by protesters or to simply brutalise their populations into submission betray the fact that for many governments, regime survival remains their aim."
In Syria, there were more than 200 cases of reported deaths in custody by the end of the year, more than 40 times the recent average annual figure, Amnesty said.
In Yemen, more than 200 people had been killed in connection with protests while hundreds more died in armed clashes.
In Bahrain, it was unclear how committed the government was to implementing reform recommendations made by an independent report, Amnesty said.
The report also said that despite the optimism that had greeted the fall of long-standing rulers in Tunisia, Egypt and Libya, concern remained that the gains had yet to be cemented by key instituitional reforms.
In Egypt, Amnesty found that the military rulers had been responsible for abuses that were "in some aspects worse than under Hosni Mubarak".
About 84 people had died under violent suppression between October and December last year, while more civilians had been tried before military courts in one year than under 30 years of his rule, it said.
In Tunisia, it was "critical" that a new constitution was drafted to ensure it guaranteed protection of human rights and equality under the law, the report said.
Amnesty also criticised international powers and regional bodies for "inconsistencies" in their response to the situations in Libya, Syria and Bahrain, and of "failing to grasp the depth of the challenge to entrenched repressive rule".
"Support from world powers for ordinary people in the region has been typically patchy," Luther said