The issue is that it’s cheap in materials but requires a colossal initial investment, so only a few companies can produce it
Yeah it might be a problem for the shed alchemist or a new business setup, but it’s not that hard for even poor and backward state. Poland for example managed to produce insulin since 1924, when it was still fucked up by last 300 years of history, and opened mass production in 1953 when it was still fucked up by WW2.
The only thing that is required is actual will to maintain some semblance of public health, which is not present in USA.
