Probably signatures could alleviate most of these issues, as each publish would require the author to actually sign the artifact, and setup properly with hardware keys, this sort of malware couldn't spread. The NPM CI tokens that don't require 2fa kind of makes it less useful though.

Clojars (run by volunteers AFAIK) been doing signatures since forever, not sure why it's so difficult for Microsoft to follow their own yearly proclamation of "security is our top concern".