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I don´t think they´re essential, but they´re important in many pizza recipes, either as a sauce or in slices.

My city has a high population of pizza lovers and thousands of pizzerias, some of our traditional/common pizza toppings that do not have tomatoes :
- Chicken with Catupiry Cream Cheese
- Broccolli/Endive with Cream Cheese
- Corn & Bacon
- Tuna & Oregano
- Chocolate
- Banana with Condensed Milk
- Guava paste & White Cheese

etc. etc. etc.