Although his appointment as FDA commissioner in 1990 by President George H. W. Bush won bipartisan approval, many of Kessler's actions were controversial, and he soon became more popular with Democrats than Republicans. He moved quickly to make the agency more efficient, cutting the time needed to approve or reject new drugs, including AIDS drugs, and more vigilant in protecting consumers against unsafe products and inflated label claims. It was also under his watch that FDA enacted regulations requiring standardized Nutrition Facts labels on food. In one memorable action, he had 24,000 gallons of Citrus Hillorange juice seized because although made from concentrate, it was labeled "fresh." Kessler was reappointed to the post of FDA Commissioner during the administration of Bill Clinton. Kessler is also known for his role in the FDA's attempt to regulate cigarettes, which resulted in the FDA v. Brown & Williamson Tobacco Corp. case. The Supreme Court ultimately ruled that the FDA did not have the power to enact and enforce the regulations in question. He was awarded the Public Health Hero award on April 2, 2008, by the UC Berkeley School of Public Health for his work in tobacco regulation. Kessler published a book entitled A Question of Intent, which gave his view of his time at the FDA, focussing on his attempts to change tobacco legislation and the interpretation of that legislation, and his battle with the then-illegal but still used Y1 strain of tobacco. Kessler also oversaw the FDA-directed moratorium on siliconebreast implant devices in 1992. This moratorium led to a deluge of lawsuits in the following months, many of which were filed prior to the federal judiciary's adoption of the Daubert standard for expert testimony in 1993. These lawsuits ultimately led to perhaps the largest settlement in the history of medical devices, Dow Corning's declaration of bankruptcy, and ongoing payments to individuals for conditions that have nothing to do with silicone. Scientific panels funded by three different government agencies conducted comprehensive assessments and later arrived independently at the same conclusion: that there was no connection between silicone gel implants and systemic disease. The FDA moratorium was lifted in 2006.
After the FDA
Kessler left the FDA to join the Yale School of Medicine as dean from 1997 to 2003. He was awarded the Public Welfare Medal from the National Academy of Sciences in 2001. In 2003 he was recruited to a post as dean and vice-chancellor at the University of California, San Francisco Medical School. After his arrival at UCSF, Kessler uncovered multiple spreadsheets for the same closed fiscal year, all showing different revenue and expense numbers, but indicating that the dean's office was in deficit and would continue to be so, in direct contravention of what had been reported to him during his recruitment, evidence of, at best, inadequate financial controls. J. Michael Bishop, Chancellor of UCSF, claimed UC audits found no evidence of financial irregularities and, in June 2007, Bishop demanded Kessler's resignation. On December 13, 2007, Kessler was formally dismissed. Then, Bishop acknowledged that the financial data presented to Kessler during his recruitment might have been misleading. Kessler alleged he was fired for whistleblowing. Subsequent to Kessler's firing, after UCSF was pressured to release one of the audits, by KPMG, it was revealed that Kessler had been correct. His 2009 book The End of Overeating highlights for the consumer the amount of fat, salt and sugar in their food intake. He asserts that this trio of elements in restaurant and processed foods conditions us to eat more in a manner that changes our brain circuitry and that children may develop a pattern of overeating and obesity that they might retain for life. He stresses that this outcome of lifelong obesity is not genetic but environmental and avoidable.
Selected publications
Kessler, David A., Capture: Unraveling the Mystery of Mental Suffering
Kessler, David A., Your Food Is Fooling You: How Your Brain Is Hijacked by Sugar, Fat, and Salt
Kessler, David A., The End of Overeating: Taking Control of the Insatiable American Appetite
Kessler, David A., A Question of Intent: A Great American Battle with a Deadly Industry
Eisdorfer, Carl, David A. Kessler, and Abby N. Spector, eds. Caring for the Elderly: Reshaping Health Policy