It's a eternal balancing act. What constitutes "safe and effective?"
Let's take money out of it, and assume all players are working at cost and experiencing no financial gain. Still, how much testing do you do? What level of safety is safe? One bad outcome in 1000? One in 100,000? And what level of "effective" is worth it? If a covid vaccine reduced your chances of getting covid by 50%, and reduced the severity of covid 50%, is that enough?
Being extreme on these questions is bad news. On one end you have the Thalidomide disaster. On the other you have the criminal insanity of denying opiates for pain relief to people who're gonna be dead in six weeks.