Four Charged in Portugal's Twins Case: Prosecutors Accuse the Former President's Son and Two Ex-Officials of Malfeasance, and the Mother of Fraud Over Wheelchairs

Nearly three years after the story first broke, prosecutors have closed their investigation into how two Luso-Brazilian twin girls came to receive one of the world's most expensive medicines at Lisbon's Hospital de Santa Maria, and have charged four people. The Ministério Público (Public Prosecution Service) announced the closing order on Monday.

What the prosecutors announced

The Ministério Público's own statement is short and names no one. It says the inquiry examined facts relating "among other things" to the administration of Zolgensma to two children with Brazilian and Portuguese nationality. Three of the defendants are accused, as co-authors, of prevaricação (malfeasance in public office) in what Portuguese law calls "apparent concurrence" with abuso de poderes (abuse of power), meaning the same conduct fits both offences. The fourth is accused of burla qualificada (aggravated fraud). The investigation was led by the 1st Section of the DIAP Regional de Lisboa (Lisbon Regional Department of Investigation and Prosecution), assisted by the Polícia Judiciária (Judicial Police).

The names, first reported by CNN Portugal and SIC, appear in the charge sheet seen by Lusa. The three accused of malfeasance are Nuno Rebelo de Sousa, son of the former President Marcelo Rebelo de Sousa; António Lacerda Sales, a former Secretary of State for Health; and Luís Pinheiro, formerly clinical director at Santa Maria. The girls' mother, Daniela Martins, is the defendant accused of aggravated fraud.

The prosecution's case

According to Lusa, which saw the charge sheet, prosecutors say that after Nuno Rebelo de Sousa's emails to his father, then President, were forwarded to the Ministry of Health, he contacted Lacerda Sales to arrange a meeting, seeking to use that fact to influence him, with the aim of having an appointment booked at Santa Maria. The appointment was made "through António Lacerda Sales, in breach of the existing rules on booking appointments in Portuguese public hospitals", knowing in advance that the aim was the Zolgensma treatment and not only the consultations. The drug costs about two million euros per child.

Prosecutors say Lacerda Sales knew that forwarding the emails to the clinical director would influence his decision, because they came from the President's son. The two officials, the charge sheet says, used their positions "to satisfy merely private interests".

The mother's charge does not concern the drug. Prosecutors accuse her of fraud over special wheelchairs supplied for the girls, saying she "knew she had no economic need" and sought to benefit from every subsidy, donation and benefit the Portuguese State made available. In a statement quoted by RTP, Daniela Martins made the same point, adding that her daughters "are children and not a case".

What the defence says, and what comes next

Rui Patrício, Nuno Rebelo de Sousa's lawyer, told Lusa the accusation "has no foundation at all, neither factual, nor legal, nor social". He is weighing whether to ask for instrução (a pre-trial review in which a judge decides whether the evidence justifies a trial), but may prefer to go straight to trial.

The girls, born in 2018, have spinal muscular atrophy, a rare genetic disease. TVI revealed the case in November 2023. The IGAS (Inspectorate-General of Health Activities) concluded that their access to a neuropaediatrics appointment was illegal. A parliamentary inquiry, whose final report was approved on 18 March 2025, found a "special intervention", without illegality, by the President's civilian office. Marcelo Rebelo de Sousa has said he gave the request "the most neutral" handling, passing it to the Government like many others. He is not a defendant.

All four are presumed innocent, and none has yet been sent to trial.