Sorry, I'm going to do the annoying blockquote thing just because your split this up so nicely into chunks for me to digest and respond to.
These type of questions are always based in the unrealistic assumption that an anarchist society would have to start from scratch and have none of the existing knowledge and production facilities.
I'm actually not trying to make that assumption here, although I should have been clearer. My response to annother commenter goes more into depth on what I'm talking about (or at least tries to, my thoughts are being updated in real time).
pharmaceuticals are actually not all that complicated to produce with modern biotechnological means.
I mean, for certain drugs and certain definitions of "that complicated," I guess kinda? But producing it at scale, in sterile conditions, at extremely specific titrations, and moving it with a cold chain to where it's needed...that's fairly specific work that isn't particularly glamorous or sometimes even healthy. Certainly, things could be done to make those things easier (bring back trains), but like...at the end of the day, you're still farming and processing genetically modified bacteria with precision. It might not be rocket science, but it's not easy. The only project I'm aware of working on making insulin something easily produced in a distributed way has been over a decade without more than a few micrograms made. And that's without the burden of patent encumberance (they tried with just human insulin, not the newer stuff we use for better quality of life), that's just "getting this to work at pharmacy scale."
And last but not least, very few modern Anarchists advocate for a single hugely destructive “revolution”, knowing full well the risks that come with that and how historically such revolutions have always just replaced the oppressors but not altered the system of oppression significantly. The idea is rather a more gradual replacement of power structures bottom up starting with municipalities and so on.
That's good to know. Building parallel tools for getting things done avoids another fear I have, which is instability. Being dependent on a system (not necessarily this system, but a lot of moving pieces have to work to keep me alive) just means death if there's too long of a break.
So the question for you should be rather how you can prepare for this likely eventuality and not some imagined hypothetical scenario where Anarchists cause a world revolution.
I'm going to be honest, this feels like trying to turn it around on me, and I don't super appreciate that, but I'm going to read it charitably anyway because text is bad at conveying those things and I'm probably wrong.
Anyway, I do have a plan. I've had to think about it a lot this past year especially, but even before then, this isn't something I suspect any diabetic has avoided thinking about. If either of those scenarios happen in the near to medium future, the answer is the same. Hold out as long as I can doing what I can to create a survivable environment for the people I'm surrounded by, and then as soon as I'm out of ways to get insulin, eat a bullet. Having dipped my toe into the shallow end of dying from that twice before, it's not worth it to continue that for several days before going out.
Sorry, I promise, I'm not trying to be combative, it's just that I'm sure there's about to be a big change, good or bad, and I'm gonna be real, right now I need a picture of a future better than this that still has me in it. And the more I refine my picture of what that world might look like, the more I realize that my existence is predicated on a lot of incentives that currently lean in the direction of keeping me alive. With new rules (or no rules), you have to wonder if the calculus still works out on the keeping you alive side. Especially when the process of doing that is so energy intensive, polluting and moralized.