At my last gig (Java), developers reviewed all third-party libraries + dependencies and manually uploaded them to a private Ivy server. I don't think that could work in the Node ecosystem, where every module seems to have 100+ dependencies.
EDIT:
There's a real security vs accessibility trade-off here. You can't be a productive web developer, according to modern standards, and review every single transitive dependency that gets pulled into your application. And it's very inefficient to have individual developers at different orgs separately reviewing the same libraries over and over again.
One would naturally turn to repository administrators to enforce stricter security standards. Maybe RubyGems could review all source code for every new version of a package and build it themselves instead of accepting uploads of pre-built artifacts. But these repositories are run by smallish groups of volunteers, and they don't have the resources to conduct those kinds of reviews. And no open-source developer wants to have to go through an App Store-like review process to upload their silly McWidget library.