I think it is paternalistic to interfere because “you know better”

I totally see where you are coming from but hear me out.

The first mention of the prime directive is a TOS episode which is an explicit allegory of the Vietnam War with federation and Klingon Empire supporting each side (they even mention it, not the name directly but something like "a war in south eastern Asia in the 20 century. Remember, this was during the war itself). This is a total valid critic of imperialism.

But interference isn’t always about coming with all the solutions and saying we know better. It can be about offering help on eye level, taking the other side serious.

Let’s take vaccination programs. It is paternalistic to roll out a program that produces results that suit you well and make you look good on paper (looking at you, Bill and Melinda Gates Foundation). It is not paternalistic to be in exchange with the locals to adjust to local needs and most and for most release the patents which didn’t happen with the covid vaccines due to the prime directive argument that only “we” know how to make vaccines safely. (I hope release is the right term, meaning making public domain)

Edit: TL;DR: Prime Directive is a good concept in it’s first mention that was generalized in the wrong direction