A lot of sci-fi's have a no-contact directive for developing worlds. There are different reasons given for this, but the one that almost no sci-fi dives into is this: pandemics.

In Earth's history, the american colonists could never be cruel enough to compete with nature. It is estimated that smallpox killed 90% of native americans.

With futuristic medical technology, the risk of a pandemic spreading from a primitive civilization to an advanced one is small. But in the other direction? Realistically, almost every time Picard broke the prime directive should have resulted in a genocidal pandemic on the natives. Too complex of a plotline, I guess.

And if the advanced civ tries to help with the pandemic they caused? The biggest hurdle to tackle would be medicine distribution and supply lines for a large population with minimal infrastructure. Some of the work could be done with robots, but it would certainly require putting lots of personel on the ground, which would likely just make the problem worse.