Now auditing dependencies, knowing that the packages you depend on aren't malicious and have no known vulnerabilities... well, that's a whole separate problem. And yeah, we don't really have a solution to that right now. The best we can do, as you say, is keep the attack surface small.
But if we did try to solve the auditing problem, the solution would have to sit on top of nix or something like it. If you can't precisely specify a dependency graph and reliably install from that specification, it doesn't matter how good your auditing is or what sort of system of trust you can create. You don't know what you're getting anyway.