Even developed areas in the US typically are stuck with one broadband provider. If you do have a second one, everywhere I've lived it's been DSL service and I've never heard anything good about it aside from being cheaper than Comcast.

Exactly, that is the real problem, the lack of competition from terrestrial networks. In the US the ISPs operate as a monopoly. In most big cities in Europe you have 3/4 providers to choose from, which reduces costs and increases the quality of service.

Not to mention the massive populations living in underdeveloped areas in Africa.

Not to mention the populations in Urban America that simply don’t have access to fiber.